The resolution of fetal hydrops using combined maternal digoxin and dexamethasone therapy in a case of isolated complete heart block at 30 weeks gestation

The development of hydrops fetalis in cases of isolated complete heart bloc k is associated with a very poor prognosis. Various pharmacological strateg ies have been proposed, involving both direct fetal access and transplacent al therapy, with inconsistent results in small numbers of subjects. The opt imal antenatal management will remain uncertain until multicentre controlle d trials are organised. We report the complete resolution of fetal hydrops at 30 weeks of gestation using combination of maternal digoxin and dexameth asone therapy, despite persistence of the complete heart block. A Caesarean section was performed at 37 weeks of gestation due to evidence of fetal in trauterine growth restriction. The baby girl is now 8 months of age and rem ains well, with a heart rate of 45-50 beats per minute on no medication and without pacing. Copyright (C) 2000 S. Karger AG, Basel.