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Fetal drug therapy represents an exciting new area of clinical pharmacology. Dynamic changes in the MPFU throughout-pregnancy create a complex physiologic situation that precludes easy predictions of the extent of maternal-fetal drug transfer. Isolated measurements of single pairs of maternal and fetal drug concentrations add little quantitative information about the extent of maternal-fetal drug transfer. More extensive serial measurements of maternal and fetal drug concentrations after empiric treatment of fetal arrhythmias are needed to improve our understanding of the pharmacologic factors contributing to success or failure of the therapy. Such data about maternal-fetal drug transfer may guide clinicians and pharmacologists toward more effective drug administration to improve our success with fetal therapy.