Merriman Jennifer B, Gonzalez Juan M, Rychik Jack, Ural Serdar H
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
J Reprod Med. 2008 May;53(5):357-9.
Neonatal survival and prognosis are closely linked with development of hydrops in cases of sustained fetal tachycardia. Several antiarrhythmic medications are available for conversion to sinus rhythm.
An 18-year-old woman had an audible fetal arrhythmia at 25 weeks' gestation. Fetal echocardiography revealed supraventricular tachycardia with worsening cardiac function at 28 weeks. Digoxin therapy was initiated and sotalol was later added for new-onset hydrops. The medications were then adjusted, and the fetus' heart rate converted to sinus rhythm with resolution of the hydrops. The patient was then managed as an outpatient with antenatal testing, serial laboratory studies and electrocardiograms until 39 weeks.
Digoxin and sotalol therapy can be successful in blocking likely nodal reentry in sustained fetal supraventricular tachycardia, thus allowing resolution of hydrops with a favorable outcome.
在持续性胎儿心动过速病例中，新生儿存活及预后与水肿的发展密切相关。有几种抗心律失常药物可用于转为窦性心律。
一名18岁女性在妊娠25周时可听到胎儿心律失常。胎儿超声心动图显示在28周时为室上性心动过速且心脏功能恶化。开始使用地高辛治疗，随后添加索他洛尔以治疗新发水肿。然后调整药物，胎儿心率转为窦性心律，水肿消退。随后该患者作为门诊患者接受产前检查、系列实验室检查和心电图检查，直至39周。
地高辛和索他洛尔治疗可能成功阻断持续性胎儿室上性心动过速中可能的结折返，从而使水肿消退并获得良好结局。
