This report describes fetal ectopic atrial tachycardia (EAT) diagnosed in 31 weeks of gestation. T"'l. Baseline FHR tachycardia represents an increase in sympathetic and or a decrease in parasympathetic autonomic nervous system tone1. These subjective findings are neither sensitive nor specific. 32 year old patient, gravida II, 31 + 0 weeks pregnant, fetal tachycardia around 245 bpm, no NIHF, immediate transplacental therapy with digoxin without flecainide. Meconium-stained amniotic fluid (a condition in which meconium, a baby’s first stool, is present in the amniotic fluid which can block fetal airways) Treatment. But again another dilemma appears: when to undertake FBS in uncomplicated fetal tachycardia? The tachycardia resolved and the neonate was delivered after 20 days of maternal treatment with propranolol. Mild fetal tachycardia is described as 161-180bpm and severe tachycardia is defined as greater than 180bpm for at least three minutes. The drug doses for direct fetal treatment were individualised according to the estimated fetal weight. Maternal electrolyte levels are checked daily during the loading dose for all antiarrhythmic agents. tachycardia. Cardiac arrhythmias are important to the acute pain practitioner, not only because they can lead to rapid decompensation of mother and baby, but prevention may be achieved with early epidural analgesia to … The treatment regimen may attempt to correct the underlying cause of fetal tachycardia, if possible. While originally applied during labor, It is our purpose to discuss the use of fetal echo- these techniques have been increasingly used cardiographic techniques to direct and monitor during the last trimester of pregnancy, prior to the treatment of fetal supraventricular tachyar- the onset of uterine contractions.' The fetal tachycardia causes include maternal fever, dehydration or anxiety, maternal ketosis, medications like anticholinergic medications, sympathomimetic medications like terbutaline, fetal movement, preterm fetus, maternal thyrotoxicosis and maternal anaemia, We know that fetal hypoxia, congenital heart anomalies and fetal tachycardia itself can cause decreased variability so one can argue that fetal tachycardia with reduced variability is not a reassuring sign and may warrant delivery. AND. Case . What Is Fetal Bradycardia In Labor and Delivery? Causes and Concerns. Lancet 2:393, 1980. praventricular tachycardia and atrial flutter/ 9. As these medications have the potential to cause significant adverse effects, we sought to examine maternal safety during transplacental treatment of fetal supraventricular tachycardia. Fetal ventricular tachycardia is always treated even if intermittent due to the increased risk of heart failure and fetal demise [14]. Normal fetal heart rate (140 beats/min) returned within 5–6 hours post inges-tion (Figure 3). Iron supplements or use of thyroxin … We present the case of a 27-year-old gravida 2 para 1 woman at 35 weeks’ gestation presenting with supraventricular tachycardia that converted to normal sinus rhythm with adenosine. The type of treatment selected depends on a number of factors including the type of the tachycardia, how many weeks pregnant you are, and if there are signs of hydrops. One option which may be available is to perform fetal blood sampling (FBS) if feasible to do so in labour. This article provides insight into the symptoms and treatment for fetal tachycardia. INTRODUCTION. Fetal heart rates should generally be measured in hospital by a medical professional. These can include tachycardia–an increased heart rate–or bradycardia, which is a slowed heartbeat. 29 year old patient, gravida I, 29 + 5 weeks pregnant, fetal tachycardia (around 260 bpm) with non … Netter’s Obstetrics and Gynecology E-Book. This will help prevent any unnecessary procedures. Causes of Growing Pains in Children? The fetal heart rate remained in sinus rhythm until the 35 th week of gestation when labor was induced due to a sudden decrease in fetal movements and amniotic fluid volume. Fetuses usually have a higher average heart rate compared to adults; however, some fetuses may suffer from a condition called fetal tachycardia. The main cause of rapid heart rate is the growth and increase in the size of the fetus. A normal baseline fetal heart rate is between 120-160 BPM. In cases of sustained fetal supraventricular tachycardia, maternal administration of digoxin, flecainide, sotalol, and more rarely amiodarone, is considered. Anemia or thyrotoxicosis in the mother can also result in fetal tachycardia. A total of 50 fetuses will be enrolled from 15 Japanese institutions. The primary treatment used for non-reassuring fetal status is intrauterine resuscitation. Fetal tachycardia is not associated with elevated heart rate, on excretion or activity. Late decelerations treatment and management If the fetal heart rate pattern is atypical, then your obstetrician will initially try to determine the underlying problem. SFx: maternal tachycardia, palpitations, flushing, headaches, dizziness, and nausea Beta agonists are rarely used because of adverse maternal and fetal effects: tachycardia… If the medications have stimulating agents, these can also cause problems to the heart rate of the baby. Sinus tachycardia secondary to maternal hyperthyroidism can be managed with antithyroid medications such as methimazole. It is chemically related to both the widely used opioid antagonist, naloxone, and the potent opioid analgesic, oxymorphone. Direct fetal treatment included use of amiodarone, adenosine, digoxin, and verapamil. The high success rate in fetuses with AF suggests that sotalol should be considered a drug of first choice to treat fetal AF. Supraventricular tachycardia is a common arrhythmia in pregnancy. The arrhythmia did not respond to transplacental therapy; therefore, cesarean section was done and arrhythmia was controlled by propranolol. Required fields are marked *. Preterm fetus is also associated with fetal tachycardia. 1: Smith R.P. Key words: fetal arrhythmias, fetal bradycardia, fetal tachycardia, treatment of fetal arrhythmias Subjects and Methods Address for reprints: M.R.C.P. Propranolol was administered to a woman beginning in the 35th week of her pregnancy because of a sustained fetal tachycardia of approximately 200 bpm. The clinical criteria for chorioamnionitis found in preterm or term women include maternal fever combined with 2 or more findings of maternal tachycardia, fetal tachycardia, leukocytosis, uterine tenderness, and/or malodorous amniotic fluid. Should conservative management with watchful wait be limited to 30-45 min, 45-90 min or more than 90 min? GERSTLE\',. This report describes fetal ectopic atrial tachycardia (EAT) diagnosed in 31 weeks of gestation. Uterine contractions which happen in the course of normal labor may temporarily (but repeatedly) interrupt the flow of oxygen to your fetus. 1–10 Without treatment, early delivery of a preterm, hydropic infant with tachycardia has equally unacceptable morbidity and mortality. These catheters are heated and excessive electrical impulse can be controlled. It has been our policy to hospitalize mothers given digoxin for fetal tachycardia in the labor and delivery suite for fetal monitoring and followed with daily ECGs. Symptoms include fever, uterine tenderness, foul-smelling amniotic fluid, purulent cervical discharge, and maternal or fetal tachycardia. T. T. '1.. Fetal tachycardia is an abnormal increase in the fetal heart rate. Fetal Tachycardia (labor and delivery) Fetal Tachycardia occurs when there is evidence of a sustained elevation of the fetal heart rate (baseline above 160 BPM) as seen on the Fetal Heart Tracings. Hence clinicians may face another dilemma in cases where fetal tachycardia is not preceded by deceleration in the absence of maternal fever. Should it be within 30-45 min, 45-90min or more than 90 min from the start of conservative management like left lateral tilt, hydration and pain control? The advantage of homeopathic treatment is that it doesn’t cause in any side effects. Lingman G, Ohrlander S, Ohlin P: Intrauterine di- fibrillation, our “threshold” for recommending goxin treatment of fetal paroxysmal tachycardia. Propranolol was administered to a woman beginning in the 35th week of her pregnancy because of a sustained fetal tachycardia of approximately 200 bpm. Amnioinfusion has no bearing on late decelerations, fetal bradycardia, or fetal tachycardia alterations in fetal heart rate (FHR) tracings. Fetal arrhythmia or congenital defect is associated with FHR more than 200 bpm. labor. in 1978. Methods and analysis The current study is a multicentre, single-arm interventional study. Most experts agree that the normal fetal heart rate range is 110-160 beats per minute. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves’ disease. PMID: 9354878 [Indexed for MEDLINE] Publication Types: M.D.. T'. There are specific heart rate ranges that are indicators of an unborn baby’s health status. The tachycardia resolved and the neonate was delivered after 20 days of maternal treatment with propranolol. The pharmacological treatment of fetal tachycardia (FT) has been described in various publications. Fetal monitoring in labor occasionally can be complicated by fetal arrhythmias. The use of intrapartum antibiotic treatment given either in response to maternal group B streptococcal colonization or in response to evolving signs of intraamniotic infection during labor has been associated with a nearly 10-fold decrease in group B streptococcal-specific neonatal sepsis 6 7 8. The cohort consisted of 44 fetuses with structurally normal hearts presenting with nonsinus tachycardia (heart rate over 180 beats per minute) at seven institutions in the Chicago area between 1987 and 1999 (Prentice Woman's Hospital and Evanston Hospital 1987–1999, Rush-Presbyterian-St. Luke's Medical Center 1991–1996, Christ Hospital and Medical Center 1996–1999, Rockford Memorial Hospital 1996–1999, Lutheran General … A normal baseline fetal heart rate is between 120-160 BPM. A 32-year-old woman, gravida 4, para 2, and abortus 1, with hypothyroidism and a history of Graves’ disease, presented at 23 6/7 weeks of gestation with a persistent fetal tachycardia. BJOG 2014; 121:1063–1070, Fetal Tachycardia (FT) is described as increase in baseline fetal heart rate (FHR) above 160bpm. On the one hand, fetal demise occurs in as many as 30% of fetuses with sustained tachycardia and hydrops. While in most cases this condition is benign, consistently elevated levels of heart rate can be associated with some of the following factors. In a fetus with supraventricular tachycardia (SVT) and cardiac failure, normal sinus rhythm (NSR) was restored with maternal digoxin therapy at 26 weeks' gestation. Regression of NIHF, spontaneous labor after premature rupture of membrans, 34 + 2 weeks pregnant. Ensure that the mother remains well hydrated. Dehydration or anxiety in the mother can also lead to fetal tachycardia. Treatment Regimens Fetal tachycardia of any form that is intermittent, not accompanied by cardiac or valve dysfunction, and present <50% of the time is best not treated, but needs to be monitored closely. Iron supplements or use of thyroxin to control hyperthyroidism is a part of the treatment. Mild fetal tachycardia is described as 161-180bpm and severe tachycardia is defined as greater than 180bpm for at least three minutes. Fetal Tachycardia (FT) is described as increase in baseline fetal heart rate (FHR) above 160bpm. Tachycardia in late pregnancy appears in every woman. However in clinical day to day practice, it’s not easy to deal with uncomplicated tachycardia because clinicians don’t have clear guidance for intervention in cases of uncomplicated fetal tachycardia in the absence of maternal pyrexia where tachycardia is not settling even when conservative measures like left lateral tilt, hydration and pain control have been explored. Also, what are causes of late decelerations of fetal heart rate? There are several homeopathic remedies that can complement the use of conventional treatment therapy in management of tachycardia in fetus. While most babies can tolerate this oxygen shortage, some cannot. In addition to the above causes, other factors like excessive fetal movements can also lead to fetal tachycardia. Extrinsic causes of fetal tachycardia should be identified and treated appropriately. The fetal tachycardia causes include maternal fever, dehydration or anxiety, maternal ketosis, medications like anticholinergic medications, sympathomimetic medications like terbutaline, fetal movement, preterm fetus, maternal thyrotoxicosis and maternal anaemia1. However there are some other symptoms that may be observed and parents should watch out for. Antibiotics should be started immediately and maintained all over delivery, to reduce neonatal and maternal morbidity (Grade B). Case for a more physiological approach to interpretation. There are no inform guidelines regarding the start of therapy and the mode of application. The protocol-defined transplacental treatment is performed for singletons with sustained fetal tachyarrhythmia ≥180 bpm, with a diagnosis of supraventricular tachycardia or atrial flutter. Certain medications like anticholinergic drugs can also contribute to elevated heart rate in the fetus. Fetal tachycardia is a condition which is characterized by heart rate higher than 160 beats per minute. Fetal distress occurs when a baby is no longer able to endure a vaginal delivery and emergency measures must be taken by medical staff. Another big question that surfaces is whether doing FBS is really justified in uncomplicated fetal tachycardia in the absence of deceleration? Amnioinfusion is used during labor either to dilute meconium-stained amniotic fluid or to supplement the amount of amniotic fluid to reduce the severity of variable decelerations caused by cord compression. It is variably defined as a heart rate above 160-180 beats per minute (bpm) and typically ranges between 170-220 bpm (higher rates can occur with tachyarrhythmias). The increases in circulating plasma volume and cardiac output in pregnancy increase a woman’s risk of developing an arrhythmia [1]. Drug treatment of fetal tachycardias. We know that fetal hypoxia, congenital heart anomalies and fetal tachycardia itself can cause decreased variability so one can argue that fetal tachycardia with reduced variability is not a reassuring sign and may warrant delivery. I.jOUIS. Antibiotic duration should be longer in case of bacteremia. But evidence shows that fetal tachycardia with reduced variability in cases of intrapartum hypoxia will always be preceded by decelerations, Dr Junaid Rafi MBBS, MRCPI, EFOG-EBCOG, DFSRH, Ipswich Hospital NHS Trust, Heath Road, Ipswich, IP4 5PD, UK, THE COVID-19 PANDEMIC – THE OUTLOOK FOR YEAR TWO – EDITOR’S COMMENTARY. Fetal goiter can also be a cause of complications at delivery such as dystocia by extending the fetal head during labor or acute respiratory failure, if the enlarged gland obstructs the airways [10]. Facial Nerve Damage Causes And Its Symptoms And Treatment, Early Signs Of Breast Cancer: Risk Factors & Treatment Options, Symptoms Of Interrupted Aortic Arch: Causes And Treatment, Common Causes Of Basophilia: Symptoms And Treatment Options, What Causes Low Fluid At 34th Weeks Of Pregnancy: Ways to Increase Amniotic Fluid, Dark Chocolate Health Benefits: Healthy Dark Chocolate Recipes, Managing Impulsivity Disorder Naturally with Diet and Vitamins. For treatment of sinus or low atrial bradycardia, fetal therapy is not required, but observation is recommended. Postpartum diagnosis of WPW syndrome. The prevalence of fetal arrhythmia is about 1% to 3% of all pregnancies and they are mostly benign. Mild anticholinergic delirium, along withsedation, recurred in the patient about an hour after receiving physostigmine, but did not require further treatment. Philadelphia: Elsevier Health Sciences; 2017 Lindsey D. Allan, M.D., Department of Paediatrics 12th Floor, Guy's Tower G y s Hospital u' London SEl 9RT, England Received: February 14, 1984 Accepted: May 3 . 10. Contact us today: (609) 359-0452. Arrhythmias are the most common cardiac complication encountered during pregnancy in women with and without structural heart disease [].In the United States, the incidence of pregnancy-related hospitalizations with arrhythmias has increased between 2000 and 2012 primarily due to increases in the incidence of atrial fibrillation and ventricular tachycardia []. But evidence shows that fetal tachycardia with reduced variability in cases of intrapartum hypoxia will always be preceded by decelerations2. Although fetal tachycardia is a serious condition, antenatal treatment in combination with careful monitoring and induction of delivery in cases with deteriorating fetal condition result in a satisfactory outcome for the majority of infants. However these medications can increase the heart rate of the little one. In the last trimester, the bottom of the growing uterus can shift the heart, which leads to disturbances in its rhythm and an increase in heart rate. The arrhythmia did not respond to transplacental therapy; therefore, cesarean section was done and arrhythmia was controlled by propranolol. In utero treatment of fetal tachycardia was first reported by Teuscher et al. Usually mothers are happy about the fetal movements, but as you can see, they can cause some problems as well. The condition of fetal tachycardia is not very clearly understood and hence there are very limited treatment options for management of serious conditions. Author information: (1)Department of Obstetrics, University Medical Center, Utrecht 3508 AB, 3584 EA, The Netherlands. This case showed effectiveness of rate control … Excessive sleepiness or fatigue in the baby. Their treatment indication differed somewhat from the American Heart Association’s Scientific Statement on Fetal Diagnosis and Treatment published in 2014 (well after initiation of this study) . Maternal fever leading to maternal ketosis is one of the leading factors. If a Category III tracing does not Conclusions —Fetal tachycardia is a serious condition in which treatment should be initiated, especially in the presence of hydrops fetalis. What is the Prognosis, Hypervitaminosis A and D: Symptoms, Side Effects and Treatment, Causes and Home Remedies of Hot Urine in Males and Females. However in clinical day to day practice, it’s not easy to deal with uncomplicated tachycardia because clinicians don’t have clear guidance for intervention in cases of uncomplicated fetal tachycardia in the absence of maternal pyrexia where tachycardia is not settling even when conservative measures like left lateral tilt, hydration and pain control have been explored. Radio-frequency ablation is useful in cases of serious life threatening conditions. Medications. .1.11,. lV.l.lJ.. These investigators concluded that sinus bradycardia in the fetal heart rate tracing during delivery or pregnancy may indicate long QT syndrome in the fetus and that these fetuses should undergo postnatal ECG to rule out or confirm a prolongation of the Q–T interval. Mild form of tachycardia during pregnancy is considered normal, as the heart works harder in order to provide the blood flow to the uterus. However, there is a risk of late recurrence. Cardiac failure was attributed to the persistent SVT. Tachycardia is a condition which is characterized by increase in heart rates beyond the normal range. Although sustained fetal tachycardia occurs rarely, it results in mortality rates of 8–27%. consequence of combined spinal-epidural analgesia during labor induction with oxytocin infusion. The goal of fetal tachycardia management and treatment is the near-term delivery of a nonhydropic fetus in sinus rhythm. Treatment Regimens Fetal tachycardia of any form that is intermittent, not accompanied by cardiac or valve dysfunction, and present <50% of the time is best not treated, but needs to be monitored closely. We may need to reassess treatment if medication is not effective in reducing your baby’s heart rate. Fetal. Fetal heart rate monitoring may be performed exter- ... • Tachycardia: FHR baseline is greater than 160 beats per minute ... tion, discontinuation of labor stimulation, treatment of maternal hypotension, and treatment of tachysystole with FHR changes. So the dilemma which clinicians face in labour is that “what duration of uncomplicated fetal tachycardia is significant and how long conservative management is safe in the absence of maternal pyrexia and deceleration’’? LUND: FETAL TACHYCARDIA DURING LABOR 643 However great or small the incidence of fetal tachycardia, it is of academic interest alone so long as the fetus remains free from danger. Fetal tachyarrhythmias occur in approximately 0.4-0.6% of all fetuses.1-3 Normal fetal heart rates range from 120-160 beats per minute (bpm Diagnosis and Treatment of Fetal Tachyarrhythmias | USC Journal I'. Ipswich Hospital NHS Trust, Heath Road, Ipswich, IP4 5PD, UK, References: The diagnosis of cardiac failure was based on ultrasound evidence of ascites and scalp edema. SILAS. Fetal heart rates should generally be measured in hospital by a medical professional. Lastly, late decelerations and fetal hypoxia during the second stage of labor could be the result of your pushing. Artificial pacemakers may be used in cases of serious arrhythmia after the child is born. FETAL TACHYCARDIA. Some of the medications given to the mother are supposed to stop premature labor. Usually it is possible to ignore the deviations from baseline caused by the ectopic beats and concentrate on the long-term variability pattern for reassurance of fetal well-being. 42 The prenatal diagnosis of long QT syndrome has been reported using fetal MCG. Pregnant women may have a higher incidence of cardiac arrhythmias. in. Brief episodes of transient fetal slowdowns that occur within a few minutes are often noted, especially in the second trimester, and are considered benign. This case showed … A common arrhythmia in pregnancy and the general population is supraventricular tachycardia (SVT) [2]. Fetal distress presents in varied ways and to differing degrees. Antibiotics are necessary for maternal systemic infections and acetaminophen can be used short-term to reduce maternal fever and subsequently to normalize the fetal heart rate. There are compelling reasons to develop a management strategy for fetal tachycardia. Fetal heart rate patterns identify which fetuses are experiencing difficulties by measuring their cardiac and central nervous system responses to changes in … J.. GINSBURG,. Sustained fetal tachycardia is defined as fetal HR greater than 160 bpm, and presents in more than 50% of the time on fetal heart monitoring [11]. Amnioinfusion has no bearing on late decelerations, fetal bradycardia, or fetal tachycardia alterations in fetal heart rate (FHR) tracings. Fetal arrhythmia or congenital heart defect or chiroamnionitis are serious causes of fetal tachycardia. Fetal tachycardia is considered significant (any range >160-180bpm) in the presence of maternal pyrexia as Chorioamnionitis is suspected. Your email address will not be published. Symptoms of the bradycardia in the fetus It is … Advancement of medical technology now allows the treatment of fetal tachycardia in-utero. Your email address will not be published. Although fetal arrhythmia might be determined as early as the 17th week, it is mostly diagnosed between the 28th and 32nd weeks. It is variably defined as a heart rate above 160-180 beats per minute (bpm) and typically ranges between 170-220 bpm (higher rates can occur with tachyarrhythmias). Aurum metallicum and Merc Sol are considered to be useful in treatment of cardiac conditions, especially when taken in low doses. Are we (mis)guided by current guidelines on intrapartum fetal heart rate monitoring? Some means of intrauterine resuscitation include: Nubain (nalbuphine hydrochloride) is a synthetic opioid agonist-antagonist analgesic of the phenanthrene series. Unfortunately if medications don’t work there are certain other options. However as research in this domain advances, better treatment options will emerge. It is not allowed taking medications for tachycardia treatment without the prescription of the doctor. There are treatment options and financial assistance available for fetal distress injuries. 15 Fetal treatment using magnesium and lidocaine has … These pacemakers are inserted in the chest and wired to the heart, so as to control and regulate electrical impulse to the heart. Fetal tachycardia is an abnormal increase in the fetal heart rate. Fetal Tachycardia (labor and delivery) Fetal Tachycardia occurs when there is evidence of a sustained elevation of the fetal heart rate (baseline above 160 BPM) as seen on the Fetal Heart Tracings. About 10% of all fetal arrhythmias are persistent supraventricular tachycardias that respond well to drug treatment. The treatment regimen comprises of using certain medications that can help in reducing the tachycardia and also prevent future episodes of the condition. Normally sleep talking is harmless and resolves on its own without any medical intervention. After vaginal delivery, one single dose of antibiotic is required. On the other hand, every antiarrhythmic medication has the potential to cause fatal proarrhythmia or serious and lasting Nalbuphine hydrochloride molecular weight is 393.91 and is soluble in H2O (35.5 mg/mL @ 25ºC) and ethanol (0.8%); insoluble in CHCl3 and ether. The treatment regimen comprises of using certain medications that can help in reducing the tachycardia and also prevent future episodes of the condition. FETUS. Complicated fetal tachycardia in the presence of decelerations or maternal fever qualify the decision for delivering the baby in view of fetal distress and suspected chorioamnionitis respectively. Amiodarone is an antiarrhythmic drug that can cause significant fetal abnormality. Treatment For Fetal Tachycardia. We may need to reassess treatment if medication is not effective in reducing your baby’s heart rate. The prevalence of fetal arrhythmia is about 1% to 3% of all pregnancies and they are mostly benign. premature delivery is lower for the latter ar- Br J Obstet Gynaecol87:340,1980. rhythmias. We report our treatment experience based on two examples. , premature amniotomy (40%) significantly correlates with bradycardia in the fetus. To err on the side of caution, possibly the majority of clinicians will still suspect infection in fetal tachycardia with reduced variability in the absence of either maternal pyrexia or preceded decelerations; however, the issue of role and duration of expectant/conservative management and absence of clear guidance from professional bodies regarding urgency of delivery bears complex fetal safety, risk management and litigation issues. Intraamniotic infection, fetal anemia, and tocolytic treatment using ritodrine would most likely result in fetal tachycardia. In utero treatment of fetal tachycardia was first reported by Teuscher et al. The type of treatment selected depends on a number of factors including the type of the tachycardia, how many weeks pregnant you are, and if there are signs of hydrops. Chemically nalbuphine hydrochloride is 17-(cyclobutylmethyl)-4,5α-epoxymorphinan-3,6α,14-triol hydrochloride. With long ventriculoatrial tachycardia, the study demonstrated 100% fetal control with sotalol, even in the one in four with hydrops fetalis. Amnioinfusion is used during labor either to dilute meconium-stained amniotic fluid or to supplement the amount of amniotic fluid to reduce the severity of variable decelerations caused by cord compression. Increasingly, fetal magnetocardiography (fMCG) is being used to determine mechanism-specific treatment (or non-treatment). Fetal tachycardia is defined as a baseline heart rate greater than 160 bpm and is considered a nonreassuring pattern . Anoxic fetal bradyeardia (,,an be controlled quickly and effectively by administration of oxygen to the mother as long as the oxygen transportation system remains intact, There is one association of fetal tachycardia and anoxia which is oecasionally observed, a tachycardia which sometimes follows the srzccessful treatment of fetal anoxia.
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