ELİF ÖZALKAYA, Hande Özgün KARATEPE, Taner YAVUZ, Selahattin AKAR, Emine KAVAS, GÜNER KARATEKİN

Hidrops Fetalis'li Supraventriküler Taşikardinin Tedavi Zamanlamasi: İntrauterin mi? Ekstrauterin mi?

Fetal taşikardi'nin %90 nedeni supraventriküler taşikardidir. Kalp hızı 220/dk üzerinde ve süreklilik gösterirse taşikardiye %40 hidrops fetalis eşlik eder. Serebral komplikasyonları önlemek için fetal taşikardinin erken dönemde kontrol altına alınması gerekir. Ancak hidrops fetalisin eşlik ettiği taşikardinin intrauterin tedavisi zor ve mortalitesi yüksektir. 32 haftalık sezaryan ile 1990 gram doğan erkek bebeğin hidrops fetalis ve fetal taşikardisi antenatal 30. gebelik haftasında dış merkezde saptanmıştı. Postnatal kalp monitorizasyonu ile izlenen bebeğin 48. saatinde supraventriküler taşikardisi gelişti. Üçlü antiaritmik tedavi ile supraventriküler taşikardi ve hidrops fetalis bulguları geriledi. Biz bu prematüre olguyu, hidrops fetalis'li supraventriküler taşikardi tedavisini ve zamanlamasını tartışmak amacı ile sunduk.

The Right Timing of The Treatment of Supraventricular Tachycardia Accompanied by Hydrops Fetalis: Intrauterine or Extrauterine?

Ninety percent of fetal tachycardia is caused by supraventricular tachycardia. If the heart rate is over 220 /minute and persistent, 40% of it is accompanied by hydrops fetalis. Fetal tachycardia should be controlled at early period to prevent serebral complications. But intrauterine treatment of tachycardia which is accompanied by hydrops fetalis is difficult and mortality of it is high. Our patient was born by cesarean section at 32 gestational week with birth weight of 1990 grams. Hydrops fetalis, fetal tachycardia was determined antenatally at 30th gestational week in another center. At the 48th hour after birth, supraventricular tachycardia was observed. The symptoms of supraventricular tachycardia and hydrops fetalis were controlled by triple antiarrhythmic therapy. We present this case to discuss the treatment of supraventricular tachycardia complicated by hydrops fetalis and the best time for treatment.

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