Fetal tachycardia associated with maternal use of pseudoephedrine, an over-the-counter oral decongestant.

We present a case of fetal tachycardia associated with maternal use of long-acting pseudoephedrine, an over-the-counter decongestant. No previous studies exist on pseudoephedrine or other over-the-counter decongestants and their effect on the fetal heart. The elevated fetal heart rate led to difficulty in interpreting a nonstress test. The normal human fetal heart rate at term is 110 to 160 beats per minute. t Drugs that can cause elevated fetal heart rates include ~-sympa­ thomimetics (e.g., terbutaline), used for inhibition of premature labor, and parasympatholytics (e.g., atropine, scopolamine), which can also diminish fetal heart rate variability. Fetal tachycardia can also be caused by abnormal maternal or fetal health conditions, such as maternal or fetal infection, fever, fetal asphyxia, fetal anemia, fetal heart failure, fetal tachyarrhythmia, and maternal hyperthyroidism.t,2