title: Prenatal diagnosis and treatment of fetal long QT syndrome: a case report.
abstract: We report a case of a fetus presenting with bradycardia, intermittent atrioventricular (AV) block, ventricular tachycardia (VT) and the signs of fetal congestive heart failure (ascites and scrotal hydrocele) during mid-gestation. Prenatal treatment with beta-adrenergic blocker (propranolol) and digitalis glycosides was prescribed because of suspicion of long QT syndrome occurring with fetal congestive heart failure. The male baby was born at 39 weeks of gestation and showed a prolonged QT interval (QTc = 492 ms) and frequent variable AV block or alternating left and right bundle branch block, depending on the atrial rate. Prenatal administration of lidocaine failed to correct the fetal VT. Conversely, propranolol decreased the attack frequency of fetal VT. Postnatal administration of the K(+) channel opener (nicorandil) successfully shortened the QT interval and improved the outcome.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Ing-Kuang
authors.initials: IK
authors.lastname: Chang
authors.forename: Ming-Kwang
authors.initials: MK
authors.lastname: Shyu
authors.forename: Chien-Nan
authors.initials: CN
authors.lastname: Lee
authors.forename: Miau-Ling
authors.initials: ML
authors.lastname: Kau
authors.forename: Yu-Hsueh
authors.initials: YH
authors.lastname: Ko
authors.forename: Song-Nan
authors.initials: SN
authors.lastname: Chow
authors.forename: Fon-Jou
authors.initials: FJ
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D001919:Bradycardia / Q000188:drug therapy / Q000532:radiotherapy; D002037:Bundle-Branch Block / Q000188:drug therapy / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006327:Heart Block / Q000188:drug therapy / Q000209:etiology; D006333:Heart Failure / Q000151:congenital / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008012:Lidocaine / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000150:complications / Q000151:congenital / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D020108:Nicorandil / Q000627:therapeutic use; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011433:Propranolol / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000209:etiology; D016216:Ultrasonography, Prenatal; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D020108:Nicorandil; D008012:Lidocaine; D011433:Propranolol