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 complica ted with diabetic coma at 28 weeks gestation. Normal foetal heart rate was recorded immediately after correction of maternal acidotic status and hydro ps eventually disappeared. The woman was delivered at 32 weeks and the baby had an uncomplicated postnatal course. We hypothesise that maternal ketoac idosis has been the precipitating factor of tachycardia and congestive hear t failure and that this case is conceptually similar to the "late death" ph enomenon, reported in cases of poorly controlled maternal diabetes. (C) 200 0 Elsevier Science Ireland Ltd. All rights reserved.