Management and long-term outcome of foetal tachyarrhythmias

Research output: Contribution to journalArticle

Abstract

Objectives. To analyse retrospectively the course in utero, responsiveness to treatment, and outcome after birth and at a long-term follow-up, of cases with foetal tachyarrhythmias. Material and methods. Thirty-six foetuses with tachyarrhythmia were followed-up in our Centre between November 1984 and December 1999, since diagnosis made at 21-39 weeks' gestation (median 27), for a median of 5 years (18 months-11 years). All had normal cardiac anatomy. Six had episodic supraventricular tachycardia (SVT) and 30 persistent SVT or atrial flutter, 14 of whom with hydrops. Results. Episodic SVT disappeared in utero in 5/6 cases. Twenty-seven of 30 cases with persistent tachyarrhythmia underwent maternal-foetal treatment with digoxin, associated with verapamil in 2 cases and to flecainide in 4. Rhythm control in utero was achieved in 19/27 cases (70.4%), digoxin alone was effective in 13 (48%), with a better response in non-hydropic foetuses. Five cases with hydrops died: 1 in utero and 4 after preterm delivery due to the premature rupture of membranes. Nine neonates presented tachyarrhythmias after birth, and 4 showed preeccitation at ECG (Wolff-Parkinson-White type). The surviving infants were followed-up for a median period of 5 years had late recurrences. One hydropic case developed, postnatally, an acquired pulmonary stenosis, and another has a residual neurological damage. Conclusions. Our data confirm a relevant mortality and morbidity in cases with foetal tachyarrhythmias, mainly when complicated by hydrops. Improved responsiveness to treatment was found in our more recent cases, thanks to new therapeutic protocols.

Original languageEnglish
Pages (from-to)41-48
Number of pages8
JournalItalian Journal of Pediatrics
Volume28
Issue number1
Publication statusPublished - Feb 2002

Keywords

  • Foetal echocardiography
  • Foetal tachyarrhythmias
  • Hydrops foetalis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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