Flack N J, Zosmer N, Bennett P R, Vaughan J, Fisk N M
Fetal Medicine Unit, Royal Postgraduate Medical School, Queen Charlotte's and Chelsea Hospital, London, United Kingdom.
Obstet Gynecol. 1993 Oct;82(4 Pt 2 Suppl):714-6.
We describe the concurrent administration of amiodarone using three different routes in order to provide: 1) rapid and adequate fetal loading without giving unduly high doses to the mother, and 2) a maintenance dose to the fetus without risking repeated invasive procedures.
Rapid atrial flutter was seen on ultrasound in a fetus with severe hydrops at 27 weeks' gestation. Following failed transplacental therapy with sotalol and flecainide, amiodarone was administered to the fetus via the intravenous, intraperitoneal, and transplacental routes. Conversion to sinus rhythm and resolution of hydrops followed this treatment.
Combined triple-route administration of amiodarone to the fetus can be effective in treating supraventricular tachycardia and may have a role in the management of life-threatening fetal arrhythmias refractory to transplacental therapy.
我们描述了使用三种不同途径同时给予胺碘酮，目的是：1）在不给母亲过高剂量的情况下，快速且充分地使胎儿达到负荷量；2）给胎儿维持剂量，而无需冒重复侵入性操作的风险。
在妊娠27周时，超声检查发现一名患有严重水肿的胎儿出现快速心房扑动。在经胎盘使用索他洛尔和氟卡尼治疗失败后，通过静脉、腹腔和经胎盘途径给胎儿使用了胺碘酮。该治疗后转为窦性心律，水肿消退。
联合经三种途径给胎儿使用胺碘酮可有效治疗室上性心动过速，并且在治疗经胎盘治疗无效的危及生命的胎儿心律失常中可能发挥作用。
