engleski

Digoxin and amiodaron in fetal sustained supraventricular tachycardia and non immune hydrops

Supraventricular tachycardia is the most common and clinically significant form of sustained fetal tachyar-rhythmia in pregnancy ; depending on duration and high rate variability heart failure and nonimmune hydrops may de-velop which are associated with a high incidence of perinatal mortality. Doppler/echo diagnosis is usually accidental during second and third trimester of pregnancy. Therapeutic goals are cardioconversion to sinus rhythm and recovery of heart failure. We present a case of fetal supraventricualr tachvcardia diagnosed at 29 weeks of gestation with nonimmune hydrops. Treatment with digoxin and amiodarone was successful. The heart rate restored to sinus rhythm and nonim¬mune hydrops resolved within three weeks of treatment. Therapy with two drugs that act synergistically may be more efficient than monotherapy in blocking likely atrio-ventricular reentry mechanism by accessory pathway in sustained supraventricular tachycardia, thus allowing resolution of hydrops with favorable management outcome.

fetalus; tachvcardia supraventricular; fetal hvdrops; digoxin; amiodarone

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