胎儿心律失常致新生儿死亡一例

A Case Report of Neonatal Death Due to Fetal Arrhythmia

大多数的胎儿心律失常是心脏胚胎发育中的良性过程,呈一过性,预后良好。而持续性的胎儿心律失常或伴有心脏结构缺陷、胎儿水肿的心律失常,可致围生儿不良结局。报道1例合并胎儿水肿的持续性快速型室上性心律失常病例,治疗期间病情反复,于妊娠36周行剖宫产术终止妊娠,新生儿出生后3 d死亡。通过回顾患者的一般情况及诊疗过程,总结经验教训,加强临床医生对疾病及其治疗方案的认识,对于胎儿心律失常的患者应当加强围生期母儿监护,制定个体化治疗方案,以改善不良妊娠结局。

Most fetal arrhythmias are benign processes in cardiac embryo development,transient and good prognosis.And persistent fetal arrhythmia or arrhythmia with heart structural defect,fetal edema,can cause perinatal adverse outcome.In this case,persistent supraventricular arrhythmia with fetal edema was treated with digoxin monotherapy,the pregnancy terminated by caesarean section at 36 weeks of gestation and the newborn died 3 days after birth.By reviewing the patient′s general situation and diagnosis and treatment process,summarizing experience and lessons,and strengthening clinicians′understanding of the disease and its treatment plan,for patients with fetal arrhythmia,perinatal maternal and child monitoring should be strengthened,and individualized treatment plans should be formulated to improve adverse pregnancy outcome.