Transplacental Therapeutic Drug Monitoring in Pregnant Women with Fetal Tachyarrhythmia Using HPLC-MS/MS.

This study focuses on transplacental therapeutic drug monitoring in pregnant women with fetal tachyarrhythmia using hplc-ms/ms.. The research employs high-performance liquid chromatography (HPLC) techniques to address analytical challenges in the clinical field. Fetal arrhythmia develops in 0.1-5% of pregnancies and may cause fetal heart failure and fetal hydrops, thus increasing fetal, neonatal, and infant mortality. The timely initiation of transplacental antiarrhythmic therapy (ART) promotes the conversion of fetal tachycardia to sinus rhythm and the regression of the concomitant non-immune fetal hydrops. The... Research Background and Significance Fetal tachyarrhythmia, a condition characterized by abnormally rapid fetal heart rates, affects approximately 0.1% to 5% of pregnancies. It poses significant risks including fetal heart failure and non-immune fetal hydrops, which contribute to increased fetal, neonatal, and infant mortality rates. Early and accurate diagnosis, alongside effective therapeutic drug monitoring (TDM), is crucial to ensuring timely intervention. Transplacental antiarrhythmic therapy (ART) aims to restore fetal sinus rhythm and reverse hydrops, thereby improving fetal outcomes. However, therapeutic drug monitoring during pregnancy is analytically challenging due to the complex biological matrices and the need for sensitive, selective, and robust quantification of antiarrhythmic drugs and their metabolites. This study by Starodubtseva et al. leverages high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) to address these challenges, providing a validated analytical approach for clinical application. Experimental Design and Methodology The study employed an HPLC-MS/MS platform to quantify antiarrhythmic drug con