Fetal tachyarrhytmias associated with the presence of anti-thyroid antibodies in maternal Graves’ disease
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Introduction: Fetal tachyarrhythmias are detected in 1-2 % of gestations. One infrequent cause is fetal hyperthyroidism, occurring in 1-5 % of mothers with Graves’ disease. The objective of this study is to determine the strategies for diagnosis, management and the clinical evolution of fetuses diagnosed with fetal tachyarrhythmia that are products of mothers with Graves’ disease.
Methods: A revision of the literature was conducted using the PUBMED database, identifying reviews that included type of arrhythmia, diagnostic strategies, and prenatal management, also we considered case reports that included the prenatal evolution of fetuses with tachyarrhythmias associated with maternal Graves’ disease.
Results: 22 reviews and 2 case reports between 1994 to 2018 were included. Supraventricular tachycardia and atrial flutter were the two more frequent tachyarrhythmias reported. The estimated gestational age of the diagnosis was 30 weeks. Pharmacological cardioversion to sinus rhythm with first line agents is more effective in the absence of fetal hydrops. Titers of anti-thyroid antibodies 3 folds of the normal range were associated with greater fetal compromise.
Conclusion: The presence of anti-thyroid antibodies in pregnant women with Graves’ disease is associated with fetal tachyarrhythmias. Pregnancy follow-up must be held by a multidisciplinary team with an active seeking for sings of thyrotoxicosis. Pharmacological transplacental cardioversion is the therapeutic choice
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