Fetal tachycardias: management and outcome of 127 consecutive cases
Key result
Transplacental treatment achieved prenatal control of tachycardia in 83% of non-hydropic fetuses and 66% of hydropic fetuses, with survival rates of 96% and 73%, respectively.
Why the study?
What are the management strategies and outcomes for fetuses presenting with tachycardia?
Population
127 consecutive fetuses with tachycardia, median gestational age at presentation 32 weeks.
Design
Cohort
Follow-up
through the neonatal period
Authors
Discussion
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Implication
Supports transplacental therapy for fetal tachycardia with better outcomes absent hydrops; leaves open optimal regimen pending prospective trials.
Study Design
Type
Cohort (n=127)
Multicenter
No
Structured PICO
What are the management strategies and outcomes for fetuses presenting with tachycardia?
P
Population
127 consecutive fetuses with tachycardia (median gestational age 32 weeks) managed at a single tertiary center between 1980 and 1996.
E
Exposure
Transplacental antiarrhythmic treatments including digoxin monotherapy, digoxin plus verapamil, and flecainide, or direct fetal treatment.
O
Outcome
Prenatal control of tachycardia and survival through the neonatal periodhard clinical
Main Result
Absolute Event Rate: 83% vs 66%
Transplacental treatment effectively controls fetal tachycardia with excellent survival in non-hydropic fetuses, whereas hydropic fetuses have higher mortality and respond better to flecainide than digoxin monotherapy.
Limitations
- Retrospective design
- No ideal treatment protocol established
Cite This Study
Simpson et al. (1998) conducted a cohort in Fetal tachycardia (n=127). Transplacental anti-arrhythmic treatment vs. Hydropic vs non-hydropic status was evaluated on Prenatal control of tachycardia (non-hydropic vs hydropic fetuses). Transplacental treatment achieved prenatal control of tachycardia in 83% of non-hydropic fetuses and 66% of hydropic fetuses, with survival rates of 96% and 73%, respectively.