Wolff-Parkinson-White Syndrome and Pregnancy: A Case of Intraoperative Supraventricular Tachycardia

Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac condition characterized by pre-excitation, which is rarely diagnosed during pregnancy. Nevertheless, during pregnancy, WPW syndrome can lead to potentially fatal arrhythmias in both the mother and fetus, with a low risk of sudden death. It is a ventricular pre-excitation disorder caused by an abnormal conduction pathway that leads to anterograde ventricular activation, bypassing the atrioventricular node. Most anti-arrhythmic drugs pose a threat to the fetus and to the breastfeeding infant, which is why they must be chosen with care. Digoxin is a drug contraindicated in adults with WPW syndrome, and certain drugs such as verapamil increase the risk of ventricular fibrillation. We report the case of a 33-year-old woman, multiparous at 40 weeks, admitted for failure to fully dilate complicated by fetal distress. The patient reported the notion of palpitation since childhood, which was never explored. Intraoperatively, she presented with supraventricular tachycardia requiring care in the operating room.