VP16.02: Management of supraventricular tachycardia diagnosed at 12 weeks: a case report
Bibliographic record
Abstract
Supraventricular tachycardia (SVT) is the most common type of fetal tachycardia. Left untreated, SVT can lead to hydrops and in-utero demise. In most cases, diagnosis is made after the first trimester. The literature is scarce concerning the appropriate management of SVT diagnosed during the first trimester. We report the outcome of a case of SVT diagnosed at 12 weeks. A 30-year-old Caucasian woman, G3P2, presented at 12 weeks for her first trimester ultrasound which revealed a severe tachycardia (292 bpm). Nuchal translucency and fetal anatomy were normal. There were no signs of hydrops. Her first trimester work-up was normal and cell free DNA testing indicated a low risk for Trisomy 21. The patient was transferred in emergency to Sainte-Justine Maternal and Fetal-Medicine Centre and fetal echocardiography at 12 weeks confirmed the diagnosis of SVT. Flecainide 100mg three times daily was initiated and normal fetal heart rhythm was restored 48h later. Serial biweekly follow-up ultrasounds continued to show normal rhythm. At 20 weeks, a small muscular ventricular septal defect (VSD) was diagnosed. Because of worsening maternal side effects, flecainide was tapered. There was no recurrence of abnormal fetal heart rhythm. At 39 weeks, she delivered a baby girl weighing 3,790g and with an Apgar score of 9-9-9. Postnatal echocardiography confirmed the VSD and diagnosed a type 2 atrial septal defect. Electrocardiogram was normal. To our knowledge, this is one of the first case of fetal SVT diagnosed and treated during the first trimester. Although the exact etiology remains speculative, treatment with flecainide was effective and lead to good outcome. Measurement of fetal heart rate during the first trimester is essential for early diagnosis of SVT without hydrops.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".