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Digoxin Therapy in the Fetus-Reply

JAMES W. HIGGINS JR, MD
Am J Dis Child. 1986;140(10):975. doi:10.1001/archpedi.1986.02140240020016.
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In Reply.—Drs De Lia and Emery raise some questions about the conclusions drawn from our study. I would agree that there is a lack of pharmacokinetic data on the use of digoxin during pregnancy. However, we cited the article by Saarikoski1 because it provides valuable data on the equilibration of intravenous digoxin in the human fetus. De Lia and Emery cite the article by Fouron, which describes the dynamics of the placental transfer of digoxin in a dog model. Saarikoski1 shows that equilibration appears to begin within a few minutes of infusion in the mother and is attained in fetal blood within 30 minutes, far less time than that cited by De Lia and Emery. In addition, the traditional treatment of choice of supraventricular tachycardia in infants and children is intravenous digoxin with a median time of conversion to sinus rhythm of six hours.2 This supports

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