Reversal of foetal hydrops and foetal tachyarrhythmia associated with maternal diabetic coma.
Foetal hydrops is always a challenge for the clinician. We report a case of tachycardia associated with hydrops and hydramnios in a pregnancy complicated with diabetic coma at 28 weeks gestation. Normal foetal heart rate was recorded immediately after correction of maternal acidotic status and hydrops eventually disappeared. The woman was delivered at 32 weeks and the baby had an uncomplicated postnatal course. We hypothesise that maternal ketoacidosis has been the precipitating factor of tachycardia and congestive heart failure and that this case is conceptually similar to the "late death" phenomenon, reported in cases of poorly controlled maternal diabetes.
Greco
P
P
Istituto di Clinica Ostetrica e Ginecologica, Università di Bari, 70124, Bari, Italy. p.greco@gynecology2.uniba.it
Vimercati
A
A
Giorgino
F
F
Loverro
G
G
Selvaggi
L
L
D000328:Adult; D003926:Diabetic Coma / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D005315:Fetal Diseases / Q000209:etiology / Q000628:therapy*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D015160:Hydrops Fetalis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D007328:Insulin / Q000627:therapeutic use; D006831:Polyhydramnios / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D013610:Tachycardia / Q000209:etiology / Q000628:therapy*; D014463:Ultrasonography
D007328:Insulin