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吗啡诱导的近足月胎儿室上性心动过速。

Morphine-induced supraventricular tachycardia in near-term fetus.

机构信息

Division of Perinatal Medicine, Policlinico Abano Terme, Piazza Colombo 1, 35031, Abano Terme, Italy.

Department of Anesthesia, University of Toronto, Toronto, ON, Canada.

出版信息

Ital J Pediatr. 2018 Sep 24;44(1):111. doi: 10.1186/s13052-018-0570-1.

DOI:10.1186/s13052-018-0570-1
PMID:30249290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6154430/
Abstract

BACKGROUND

Fetal supraventricular tachycardia (SVT), characterized by fetal heart rate between 220 and 260 bpm, is a rare but most commonly encountered fetal cardiac arrhythmia in pregnancy that may be associated with adverse perinatal outcome.

CASE PRESENTATION

We describe a 36/6 week near term fetus who presented morphine-induced SVT after maternal treatment of a renal colic. Following emergency cesarean section, the neonate had resolution of symptoms.

CONCLUSIONS

The pathophysiology of morphine-related SVT, previously documented in experimental animal models, and for the first time reported in the human fetus, is presented.

摘要

背景

胎儿室上性心动过速(SVT)的特征是胎儿心率在 220 至 260 bpm 之间,是妊娠中最常见但也是罕见的胎儿心律失常之一,可能与围产期不良结局有关。

病例介绍

我们描述了一例 36/6 周足月胎儿,在母亲治疗肾绞痛后出现吗啡诱导的 SVT。紧急剖宫产术后,新生儿症状缓解。

结论

本文首次在人类胎儿中报道了吗啡相关 SVT 的病理生理学,此前在实验动物模型中已有相关记载。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d488/6154430/7c247319cde9/13052_2018_570_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d488/6154430/7c247319cde9/13052_2018_570_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d488/6154430/7c247319cde9/13052_2018_570_Fig1_HTML.jpg

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本文引用的文献

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Intravenous Morphine vs Intravenous Ketofol for Treating Renal Colic; a Randomized Controlled Trial.静脉注射吗啡与静脉注射氯胺酮-丙泊酚用于治疗肾绞痛的随机对照试验
Emerg (Tehran). 2016 Nov;4(4):202-206.
2
Late Pregnancy β Blocker Exposure and Risks of Neonatal Hypoglycemia and Bradycardia.孕晚期β受体阻滞剂暴露与新生儿低血糖和心动过缓风险
Pediatrics. 2016 Sep;138(3). doi: 10.1542/peds.2016-0731.
3
Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association.胎儿心脏疾病的诊断与治疗:美国心脏协会科学声明
Circulation. 2014 May 27;129(21):2183-242. doi: 10.1161/01.cir.0000437597.44550.5d. Epub 2014 Apr 24.
4
Fetal supraventricular tachycardia, treating the baby by targeting the mother.胎儿室上性心动过速,通过针对母亲来治疗胎儿。
BMJ Case Rep. 2013 Apr 15;2013:bcr2012008515. doi: 10.1136/bcr-2012-008515.
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Comparison of transplacental treatment of fetal supraventricular tachyarrhythmias with digoxin, flecainide, and sotalol: results of a nonrandomized multicenter study.比较胎儿室上性心动过速的经胎盘治疗与地高辛、氟卡尼和索他洛尔:一项非随机多中心研究的结果。
Circulation. 2011 Oct 18;124(16):1747-54. doi: 10.1161/CIRCULATIONAHA.111.026120. Epub 2011 Sep 19.
6
Drugs and medicines in pregnancy: the placental disposition of opioids.妊娠期用药:阿片类药物在胎盘的处置。
Curr Pharm Biotechnol. 2011 May;12(5):797-803. doi: 10.2174/138920111795470859.
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Overview of fetal arrhythmias.胎儿心律失常概述。
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