- 作者：Marouane Boukhris ; Kaouathar Hakim ; Nidhal Ben Moussa ; Hela M&rsquo ; saad ; Fatma Ouarda ; Rafik Boussaada
- 刊名：Journal of the Saudi Heart Association
- 出版年：2013
- 出版时间：April, 2013
- 年：2013
- 卷：25
- 期：2
- 页码：143
- 全文大小：46 K
Background
Fetal heterotopic tachycardia is associated with a high risk of congestive heart failure, fetal hydrops and intrauterine death. Transplacental treatment by antiarrhythmic agents can improve prognosis dramatically.Objectives
The aim of our study is to review the management and the outcome of heterotopic tachycardia in fetal patients treated in our center.
Methods
We reported 24 cases of heterotopic fetal tachycardia diagnosed and treated mainly with digoxin and/or amiodarone administered by the transplacental way.
Results
Twenty four fetal patients were studied, thirteen with supraventricular tachycardia, eight with atrial flutter and three with chaotic atrial tachycardia. Among them, eight fetuses were hydropic. All mothers were given an antiarrythmic treatment by mouth. There were three intrauterine deaths. Digoxin monotherapy converted 6/8 non hydropic fetuses and 0/2 hydropic fetuses who died. Amiodarone monotherapy converted 4/6 including 2 hydropic fetuses with one intrauterine death. The association of digoxin and amiodarone converted 7/7 fetuse including 3 hydropic patients. No death found with this association. Propanolol was used in monotherapy or associated with digoxin in vain in three patients with chaotic atrial tachycardia.
Conclusions
Maternal oral antiarrhythmic treatment should be given as soon as the diagnosis of fetal heterotopic tachycardia is done. Digoxin and amiodarone seems to be effective. Their association is particularly indicated in hydropic fetuses.