Fetal supraventricular tachyarrhythmia with subsequent hydrops was associated with the development of severe cerebral complications, including hypoxic-ischemic and hemorrhagic lesions, in three cases.
Case Report (n=3)
Are fetuses with supraventricular tachyarrhythmia and subsequent hydrops at increased risk for cerebral complications?
Fetal supraventricular tachyarrhythmia leading to hydrops may cause severe cerebral complications, highlighting the need for immediate and complete heart rate control.
BACKGROUND: Fetal tachyarrhythmia is a well-documented entity which, in the absence of pharmacological intervention, may lead to congestive heart failure, fetal hydrops and eventually fetal demise. The success rate of the implemented treatment is generally measured by survival and achievement of control of the arrhythmia. We report on the occurrence of associated cerebral damage in three patients with fetal tachycardia. METHODS: We describe three patients with a history of fetal supraventricular tachyarrhythmia who developed cerebral complications in utero. RESULTS: Two patients had cerebral hypoxic-ischemic lesions and one had hemorrhagic lesions present at birth. They had developed severe congestive heart failure and fetal hydrops secondary to fetal tachyarrhythmia, and there were no other obvious causes for the cerebral pathology. Two of these patients were referred to us antenatally. Therapy was instituted and resulted in control of the tachycardia and resolution of hydrops. The third patient was referred to our clinic shortly after birth because of severe circulatory problems secondary to fetal tachyarrhythmia. CONCLUSION: From these observations, we believe that a fetus with tachyarrhythmia and subsequent hydrops is at increased risk for the development of cerebral complications, due to the circulatory disturbances and sudden changes in heart rate which may lead to fluctuations in cerebral perfusion. This would imply that it is of the utmost importance to aim at immediate and complete control of the heart rate in the treatment of fetal tachyarrhythmia.
Schade et al. (Fri,) conducted a case report in Fetal supraventricular tachyarrhythmia (n=3). Fetal supraventricular tachyarrhythmia was evaluated on Cerebral complications (hypoxic-ischemic or hemorrhagic lesions). Fetal supraventricular tachyarrhythmia with subsequent hydrops was associated with the development of severe cerebral complications, including hypoxic-ischemic and hemorrhagic lesions, in three cases.