[SCD-FORUM] 84E. LQTS in pregnancy. Dr. Zaklyazminskaya

[SCD Symposium]

Dear organizers and colleagues! Thank you for interesting and useful
educational materials and remarkable discussion! I'd like to ask your  
advise
about my patients applied  genetic counselling last week. Patient is  
young
woman (24 years old) with LQTS, QTc-480-495 ms, with pre-syncope  
events in
your adolescence but not at present time.
She was treated by beta-blockers before 19 years old and had been  
canceled
medication self-dependent. She is in her 18 weeks of pregnancy  
without any
symptoms or specific discomfort. I have some doubt about absence of
medication in this situation.  In 4 known generation we have information
about 4 additional relatives with mild course of disease and none SCD
events. Now we verified KCNQ1 mutation in all affected family members  
and
going to diagnose LQTS for baby synchronous with blood sampling for  
newborn
metabolic screening (4 day old in Russia).
My questions are:
1/ Is it advisable to recommence beta-blockers now?
2/ Do you know any side effects due to beta-blockers further to  
possible A-V
block for fetus?
3/ What are yours recommendations for therapy in postpartum and  
lactation ?
4/ Not only for this patient. Is the strategy of mother's therapy   
differ
against child status (affected/non-affected, mutation carrier/non- 
carrier)
during lactation taking into account extraction of beta-blockers with  
the
milk?
Thank you in advance for all opinions and consultations!

Dr. Elena Zaklyazminskaya, M.D., Ph.D.
Russian Research Center for Medical Genetics,
1, Moskvorechie, Moscow, Russia, 115478
dnalab at rol.ru
www.dnalab.ru

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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