Successful treatment of refractory supraventricular tachycardia by repeat intravascular injection of amiodarone in a fetus with hydrops

We report the case of a fetus with supraventricular tachycardia complicated by congestive heart failure and ascites. After failure of initial transpla cental treatment, the injection of amiodarone into the umbilical vein combi ned with evacuation of ascites achieved conversion to sinus rhythm and rest ored cardiac function thus allowing pregnancy to go to term. This report su ggests that direct fetal therapy by umbilical vein puncture and evacuation of effusions constitutes an effective treatment for supraventricular tachyc ardias with massive fetal hydrops which do not respond to transplacental tr eatment. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.