Gayón Vera Eduardo, López Candiani Carlos, Carrera González José Ernesto
Fundación Clínical Médica Sur. México.
Ginecol Obstet Mex. 2009 Dec;77(12):583-8.
Cardiac tumors are rare entities at any age. The reported incidence in fetal echocardiograms is 0.17%. This case report presents the detection of a cardiac rhabdomyoma in a 27.5 weeks of gestational age (WGA) fetus during a routine sonogram. Treatment with terbutaline, as a cardiac inotropic and chronotropic agent, was started because of fetal bradichardia of 86 beats per minute, as well as fetal lung maturity inductors. At 30 WGA furosemide was added because of fetal hydrops. At 32 WGA a cesarean section was performed. The fetal development at the time of birth was in accordance to the gestational age, the newborn weight was 1,820 g and the Apgar score was 1-0, at one and five minutes after delivery. The newborn died immediately after the interruption of the umbilical circulation, because of a 90% obstruction of the left ventricular cavity caused by the tumor. The present case is an evidence of the utility of a medical treatment in a severely ill fetus, that allowed it to continue with its normal development for four weeks after the diagnosis and opens the possibility for fetal medical therapy in the future for similar cases.
心脏肿瘤在任何年龄段都较为罕见。胎儿超声心动图报告的发病率为0.17%。本病例报告介绍了在一次常规超声检查中,于孕27.5周胎儿中检测到心脏横纹肌瘤。因胎儿心率每分钟86次出现心动过缓以及为促进胎儿肺成熟,开始使用特布他林作为心脏变力性和变时性药物进行治疗。孕30周时,因胎儿水肿添加了速尿。孕32周时进行了剖宫产。出生时胎儿发育符合孕周,新生儿体重1820克,出生后1分钟和5分钟时阿氏评分分别为1 - 0。新生儿在脐循环中断后立即死亡,原因是肿瘤导致左心室腔90%梗阻。本病例证明了对重症胎儿进行药物治疗的效用,该治疗使胎儿在诊断后能继续正常发育四周,并为未来类似病例的胎儿医学治疗开辟了可能性。