van Gelder-Hasker M R, de Jong C L, de Vries J I, van Geijn H P
Department of Obstetrics and Gynaecology, Free University Hospital, Amsterdam, The Netherlands.
Obstet Gynecol. 1995 Oct;86(4 Pt 2):667-9. doi: 10.1016/0029-7844(95)00028-p.
Fetal supraventricular tachycardia is most often treated by maternal application of digoxin. A drug used for second-choice therapy is flecainide acetate.
For a case in which maternal digoxin therapy failed, flecainide caused a lowering of the fetal heart rate (FHR) but, simultaneously, variability and accelerations nearly disappeared. The fetus demonstrated a normal movement pattern. Fetal well-being during delivery was assessed by regular ultrasound observations of fetal movements. Flecainide was not continued after birth, and digoxin therapy was started when tachycardia reappeared. The heart rate changed into a reactive pattern 5 days after birth. Around that time, flecainide levels in the neonatal serum were below the limit of detection.
Flecainide use can cause the absence of accelerations and poor variability in the FHR.
胎儿室上性心动过速最常通过母体应用地高辛进行治疗。用于二线治疗的药物是醋酸氟卡尼。
对于一例母体地高辛治疗失败的病例，氟卡尼使胎儿心率（FHR）降低，但同时，变异性和加速几乎消失。胎儿表现出正常的运动模式。分娩期间通过定期超声观察胎儿运动来评估胎儿健康状况。出生后未继续使用氟卡尼，心动过速再次出现时开始用地高辛治疗。出生5天后心率转变为反应性模式。大约在那个时候，新生儿血清中的氟卡尼水平低于检测限。
使用氟卡尼可导致胎儿心率加速缺失和变异性差。
