Fetal demise despite successful medical conversion of supraventricular tachycardia causing hydrops and acceptable fetal cardiovascular profile score : case report

• Published in: Gülhane Tip Dergisi 2015-06, Vol.57 (2), p.170
• Main Authors: yozgat, yilmaz, Kurtulmus, Secil, Taner, Cuneyt, oner, taliha, Doksoz, Onder, Ozdemir, Rahmi, Mese, Timur
• Format: Article
• Language: eng ; tur
• Subjects: Cardiac arrhythmia; Fetuses; Well being
• ISSN: 1302-0471; 2146-8052
• DOI: 10.5455/gulhane.26379

Fetal tachyarrhythmia is a well-recognized cause of non-immune hydrops fetalis. Without treatment, it may progress to hydrops fetalis and in utero fetal death. The prognosis of hydrops fetalis is highly dependent on rapid response to antiarrhythmic therapy, gestational age, fetal well being and high cardiovascular profile score (CVPS). We report here a case of severe hydrops secondary to supraventricular tachycardia (SVT) detected in 28 weeks of gestation. We presented this case to discuss CVPS. Maternally administered drug combinations including digoxin and sotalol successfully converted the disordered cardiac rhythm to sinus rhythm within 1 day. However, the fetal health failed to improve, hydrops fetalis worsened and the fetus died in utero after 21 days of treatment. The fetal CVPS was 7/10 (2 points deducted for skin edema, 1 for ductus venosus atrial reversal). It was a score, which is considered compatible with life. However, the fetus died despite an acceptable average CVPS score of 7. CVPS score could be misleading in determination of prognosis in hydrops fetalis secondary to SVT.