[Fetal supraventricular tachycardia associated with anasarca: poor prognosis despite treatment. Apropos of two cases].
Two cases of foetal supraventricular tachycardia with hydrops with fatal outcomes illustrate the poor general prognosis of this condition. The absence of therapeutic consensus, of large series in the existing literature, does not prevent logical and reasonable management based on rhythmological, pharmacological and prognostic criteria. A combined approach associating antiarrhythmic therapy by the transplacental and intrafunicular approaches seems acceptable now that funicular puncture can be undertaken easily, and certain antiarrhythmic molecules suggest encouraging results. It is important to try to assess the haemodynamic tolerance by foetal Doppler echocardiography because the foetal prognosis depends on ischaemic cerebral lesions induced by anoxia, difficult to diagnose in utero: when observed, aggressive and occasionally dangerous therapies to foetus and mother may be justified in these extreme situations of foetoplacental hydrops.
Zimmermann
C
C
Clinique Saint-Joseph, Colmar.
de Geeter
B
B
Zimmermann
A
A
Gottwalles
Y
Y
Boulenc
J M
JM
D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000196:embryology / Q000628:therapy; D001282:Atrial Flutter / Q000000981:diagnostic imaging / Q000196:embryology / Q000628:therapy; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000196:embryology / Q000628:therapy; D004452:Echocardiography; D004695:Endocardial Fibroelastosis / Q000000981:diagnostic imaging* / Q000196:embryology / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology / Q000628:therapy; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging* / Q000196:embryology / Q000628:therapy; D011247:Pregnancy; D011379:Prognosis; D013617:Tachycardia, Supraventricular / Q000000981:diagnostic imaging* / Q000196:embryology / Q000628:therapy; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal