Sinustachycardia and pregnancy

[Nurse1966]

Hello, I'm an ICU nurse and don't do baby's or momma's! but my daughter is 36 weeks pregnant and has questions. I'm NOT looking for medical advice. A little background, she's being seen by her gyn, primary care and cardiologist. No one seems to know how to treat her when her heart rate goes up to 150-160. She's taking cardizem, but they're not real crazy about increasing her dosage because of the effects on the baby. They also are telling her it's unlikely that she should breast feed. And that the calcium channel blocker can inhibit uterine contractions, decreasing the effectiveness of labor and increasing risk of postpartum bleeding.

So, NOT medical advice...what else should we be thinking about? what questions should we be asking? The gyn is a little out of her league with the situation and the cardiologist is researching what to recommend...if she weren't preggers I'd just jack up the cardizem drip and start oral meds until it came down, but I don't think ya'll handle things quite the same way!

What do lactation consultants say about mom's taking medication while breastfeeding?

Again, NOT looking for medical advice, looking for questions or direction, or even stories of similar circumstances!

Thanks!

[Rose_Queen, BSN, MSN, RN]

I think you're still technically asking for medical advice. If your daughter's OBGYN is out of his/her league, perhaps request a referral to a high-risk OB.

[Jolie, BSN]

The list of medications that are truly contra-indicated with breastfeeding is quite short.

Please refer to Dr. Sears information on medication compatibility with breastfeeding and discuss this with your doctors.

Best of luck.

[Nurse1966]

How do doctor's feel about asking for a high risk OB? and is this even a "high risk" situation? I don't know how all that works, both my pregnancy's were normal and a long time ago. If a patient gets into a sticky situation, do they normally call in someone? do they "consult" with each other to trouble shoot? Seriously, I'm not looking for medical advice about meds or treatment, just trying to understand the terms and how your world works. Every specialty has it's own way of doing things....and that's what I'm trying to understand....

[rn/writer, RN]

Who cares what the doc thinks? I get trying to be respectful of a practitioner, but if this is something they're not well-versed in, ask around and try to find a doc who won't be making it up as they go along. I'm sure your daughter's OB is a fine person, but that's not the issue.

Ask about a high risk OB or talk to your co-workers in the ICU (or ask in the CCU) and see if they know of a cardiologist who works with pregnant patients. Lots of women with cardiac issues are having babies who even ten years ago would have been advised not to. That requires some heavy-duty assistance, so that means it's out there.

I guess I'd start with a referral to a high-risk OB, and go from there.

Jolie gave you great advice about Dr. Sears' book that talks about meds and breastfeeding.

That's as far as we can go.

I hope everything works out well for you, your daughter, and that precious babe.

Thread closed.