Multiple antiarrhythmic transplacental treatments for fetal supraventricular tachyarrhythmia: A protocol for systematic review and meta analysis

Medicine (Baltimore). 2020 Dec 11;99(50):e23534. doi: 10.1097/MD.0000000000023534.

Abstract

Background: Fetal supraventricular tachyarrhythmia is a common reason for referral to fetal cardiology. Multiple antiarrhythmic transplacental medications can be used to treat these diseases. Debates remain regarding the standardized therapy.

Methods: PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov will be searched from inception to September 2020. A handsearching for gray literature, including unpublished conference articles, will be performed. The randomized control trials, case-control, and cohort studies will be accepted, no matter what the languages they were reported. We will first focus on the effectiveness of the therapy on fetal cardiac rhythm and/or heart rate. Then we will do further analysis of preterm delivery, fetal hydrops, intrauterine fetal demise, and maternal side effects. The Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale will be used to assess the risk of bias of the randomized controlled trials, case-control, and cohort studies, respectively. Two independent reviewers will carry out literature identification, data collection, and study quality assessment. Discrepancies will be resolved by a third reviewer. Statistical analysis will be conducted using the STATA 13.0 software.

Result: The results will provide helpful information about the effect of multiple antiarrhythmic transplacental therapies in pregnancies with supraventricular tachycardia or atrial flutter, and demonstrate which therapy is more effective.

Conclusion: The conclusion drawn from this systematic review will benefit the patients with fetal supraventricular tachyarrhythmia.

MeSH terms

  • Anti-Arrhythmia Agents / administration & dosage
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Flutter / drug therapy
  • Atrial Flutter / embryology
  • Drug Therapy, Combination
  • Female
  • Humans
  • Maternal-Fetal Exchange
  • Meta-Analysis as Topic
  • Pregnancy
  • Systematic Review as Topic
  • Tachycardia, Supraventricular / drug therapy
  • Tachycardia, Supraventricular / embryology*

Substances

  • Anti-Arrhythmia Agents