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July 2019

2 men jpeg Associate Professor Ricardo Palma-Dias and Dr Darren Hutchinson.

The Women’s joins world leaders in unborn baby heart trial

The Royal Women’s Hospital has joined an international trial investigating the best way to slow the dangerously-racing hearts of sick unborn babies without compromising the care of their mothers.

The FAST Therapy Trial will assess the benefits and side-effects of three drugs – sotalol, flecainide and digoxin – commonly used to treat foetal atrial flutter and supraventricular tachycardia (fast heart rhythm).

About 20 Victorian foetuses will be treated each year for racing hearts up to 250 beats per minute, which can be fatal within days if not treated.

The Women’s head of foetal cardiology and principal investigator Darren Hutchinson said he hoped the trial, over the next five years would define what treatment was best.

‘The treatments are ones we use all the time,’ Dr Hutchinson said.

‘It’s a matter of which drug is given first and which combination.

‘It will give families confidence that the treatment we’re providing is based on strong internationally-recognised data.’

Head of The Women’s ultrasound service Ricardo Palma-Dias described how the rare heart condition affected unborn babies.

‘In foetal medicine, we treat the foetus as our primary patient but this is a conundrum where, to treat the foetus, we have to treat the mother,’ Associate Professor Palma-Dias said.

‘We have to load the mother with drugs and that comes with a level of risk, complications and side effects.

‘We have to take into account not only fixing the baby, but also inflicting the least possible range of complications on the mother – that balance is thin sometimes.’

‘At the moment, it ends up being almost physician’s choice,’ Dr Hutchinson said.

‘We want to get the baby better quicker with the least side effects for the mother.

‘That’s the magic combination.’

Dr Hutchinson said The Women’s involvement in the international trial was a great coup.

‘It’s an incredible opportunity for us to be in the thick of it, rather than just watching from the sidelines.

‘For the duration of the trial we will have access to the world leaders in foetal medicine, which is very exciting.’

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