Tang Jiao, Huang Pujue, Deng Xue, Zhao Lijuan, Zhai Yang, Wang Tao
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Pediatr. 2024 Dec 17;12:1509158. doi: 10.3389/fped.2024.1509158. eCollection 2024.
It is estimated that 1%-2% of pregnancies are complicated by fetal arrhythmias, with most arrhythmias considered benign and not requiring further treatment or intervention. However, persistent tachyarrhythmias can lead to fetal heart failure, preterm birth, stillbirth, and increased risks during the perinatal period. Therefore, timely treatment during pregnancy is often necessary. Currently, prenatal treatment for fetal tachyarrhythmias (FTs) is primarily drug based, aiming to restore normal fetal heart rate, prevent or reverse fetal heart failure, and avoid adverse outcomes such as preterm birth and stillbirth. Despite decades of clinical experience, the lack of prospective, multicenter randomized clinical trials on the safety and efficacy of drugs means that there is still no universally accepted prenatal treatment regimen for FTs, and treatment relies on series of observational studies or clinical cases. Moreover, all drug treatments carry potential risks to the mother, fetus, and pregnancy, hence the need for more clinical diagnostic and therapeutic experience to provide more clinical evidence for prenatal treatment of FTs.
据估计，1%-2%的妊娠会并发胎儿心律失常，大多数心律失常被认为是良性的，无需进一步治疗或干预。然而，持续性快速心律失常可导致胎儿心力衰竭、早产、死产以及围产期风险增加。因此，孕期往往需要及时治疗。目前，胎儿快速心律失常（FTs）的产前治疗主要以药物为主，旨在恢复正常胎儿心率，预防或逆转胎儿心力衰竭，避免早产和死产等不良后果。尽管有几十年的临床经验，但缺乏关于药物安全性和有效性的前瞻性、多中心随机临床试验，这意味着目前仍没有普遍接受的FTs产前治疗方案，治疗依赖于一系列观察性研究或临床病例。此外，所有药物治疗都对母亲、胎儿和妊娠存在潜在风险，因此需要更多的临床诊断和治疗经验，为FTs的产前治疗提供更多临床证据。
