{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:48:15Z","timestamp":1791402495988,"version":"4.3.3"},"reference-count":13,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,30]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>Supraventricular tachyarrhythmia (SVT) is the most common form of fetal tachyarrhythmias. The presentation can vary from ill-defined, non-sustained episodes of tachyarrhythmia to frank non-immune hydrops. The standard of care is transplacental therapy by treating the mother with oral antiarrhythmic drugs, followed by direct fetal therapy in refractory cases. We report a case of primigravida in her late 20s, who presented at 28.1 weeks of gestation with fetal hydrops and SVT. She was initially managed with oral digoxin and flecainide, but due to worsening hydrops, risk of fetal demise and extreme prematurity, further management by direct fetal therapy was given in terms of intramuscular digoxin and intraperitoneal flecainide. Following which, the fetus had a favourable outcome. This case highlights the possible role of direct fetal therapy in refractory cases of SVT.<\/jats:p>","DOI":"10.1136\/bcr-2023-255808","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T12:10:29Z","timestamp":1703765429000},"page":"e255808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Refractory supraventricular fetal tachycardia as a cause of non-immune hydrops: management conundrum"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2047-3326","authenticated-orcid":false,"given":"Akanksha","family":"Agarwal","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subash Chandra","family":"Saha","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanjot","family":"Kaur","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Naganur","sequence":"additional","affiliation":[{"name":"Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"2025082711084103000_16.12.e255808.1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/00006254-198502000-00002","article-title":"Fetal supraventricular tachycardia. 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First\u2010Line antiarrhythmic transplacental treatment for fetal tachyarrhythmia: a systematic review and Meta\u2010Analysis. 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