AGGRESSIVE DIRECT TREATMENT OF A FETUS WITH SUPRAVENTRICULAR TACHYCARDIA AND HYDROPS-FETALIS

We report a case, in which direct fetal therapy by amiodarone injected into the umbilical vein during the last trimester of pregnancy was us ed for the treatment of fetal supraventricular tachyarrhythmia in the presence of severe hydrops fetalis. Eight injections were needed due t o the recurrence of supraventricular tachycardia 1-9 days after the in itial normalization of fetal tachycardia after each puncture. A severe fetal hydrops was maintained despite the achievement of sinus rhythm, and thus two ascites draining procedures were performed during the la st 3 days before delivery to expand the fetal lungs. A normorhythmic h ydropic baby was born by Cesarean section at 34 weeks + 6 days. Only m ild respiratory difficulties occurred after birth. Her electrocardiogr am suggests a Wolff-Parkinson-White syndrome but the overall recovery has been uneventful.