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首页> 外文期刊>Annals of Pediatric Cardiology >Clinical presentation, management, and postnatal outcomes of fetal tachyarrhythmias: A 10-year single-center experience
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Clinical presentation, management, and postnatal outcomes of fetal tachyarrhythmias: A 10-year single-center experience

机译：胎儿快速性心律失常的临床表现，治疗和产后预后：10年的单中心经验

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Background: Limited information is available regarding the prevalence and outcomes of fetal tachyarrhythmias from the developing countries. Aims: This study aims to report referral patterns, management protocols, and pregnancy outcomes of fetuses with tachyarrhythmias reporting to a single center in South India. Methods: All fetuses with documented sustained fetal tachyarrhythmia during the study period (2008–2017) were included. Arrhythmia characterization and hemodynamic evaluation were done using fetal echocardiography. Patients were grouped into supraventricular tachycardia (SVT) and atrial flutter (AF) groups. Patient characteristics, transplacental therapy (TPT), pregnancy, and postnatal outcomes were analyzed. Results: Total of 19 fetuses included; 11 had SVT and 8 AF. Mean gestational age at referral was higher for AF (32.5 ± 3.2 vs. 29.6 ± 3.3 weeks; P = 0.05). Hydrops fetalis was present 8 (42%) fetuses; 4 in each group. TPT was instituted in 18 fetuses; 12 (66.7%) received combination therapy; 4 (21%) received direct fetal therapy. Eighteen fetuses (91%) were born alive with one intrauterine death in a fetus with SVT and severe hydrops. Seven (87.5%) fetuses with hydrops survived. Twelve patients (66.7%) were delivered in sinus rhythm. Six babies (33.3%) had tachycardia at birth requiring anti-arrhythmic therapy. All patients survived the neonatal period. Duration of trans-placental therapy (3.8 + 3.3 vs. 7.3 + 3.4 weeks) was shorter in the AF group. Conclusions: Aggressive TPT using combination of drugs achieves excellent pregnancy and postnatal outcomes in fetuses with tachyarrhythmia. Early diagnosis and prompt referral before hemodynamic decompensation is critical for ensuring optimal outcomes.
机译：背景：来自发展中国家的有关胎儿快速性心律失常的发生率和结果的信息有限。目的：本研究旨在向印度南部的一个中心报告患有快速性心律失常的胎儿的转诊方式，治疗方案和妊娠结局。方法：纳入研究期间（2008-2017年）所有记录有持续性胎儿快速性心律失常的胎儿。心律失常的表征和血流动力学评估使用胎儿超声心动图进行。将患者分为室上性心动过速（SVT）和房扑（AF）组。分析患者的特征，胎盘治疗（TPT），妊娠和产后预后。结果：共纳入19例胎儿。 11具SVT和8 AF。 AF转诊时的平均胎龄较高（32.5±3.2 vs. 29.6±3.3周; P = 0.05）。胎儿积水8例（42％）胎儿。每组4个。 TPT在18个胎儿中建立; 12（66.7％）人接受了联合治疗; 4（21％）人接受了直接胎儿治疗。患有SVT和严重积水的胎儿中有18例胎儿（91％）活着出生，宫内死亡。七例（87.5％）患有水肿的胎儿幸存下来。 12例患者（66.7％）以窦性心律分娩。六个婴儿（占33.3％）在出生时患有心动过速，需要抗心律失常治疗。所有患者均存活于新生儿期。 AF组经胎盘治疗的持续时间较短（3.8 + 3.3 vs. 7.3 + 3.4周）。结论：积极的TPT联合药物可在患有快速性心律失常的胎儿中获得出色的妊娠和产后预后。血流动力学失代偿前的早期诊断和及时转诊对于确保最佳结果至关重要。

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