Journal of Ultrasound in Medicine, Vol 15, Issue 6 453-458, Copyright © 1996 by American Institute of Ultrasound in Medicine
Rate-based management of fetal supraventricular tachycardia
W. G. Guntheroth, D. R. Cyr, L. E. Shields and H. V. Nghiem
Department of Pediatrics (Cardiology), University of Washington School of Medicine, Seattle 98195-6320, USA.
We reviewed the ultrasonographic studies and the clinical course of 22
fetuses with supraventricular tachycardia to determine whether the heart
rate alone could serve as a basis for conservative management. Hydrops was
not encountered with heart rates under 230 beats per minute. The conditions
of all 22 fetuses stabilized without invasive administration of
medications. Eighteen were delivered vaginally and only four by cesarean
section. No fetal or neonatal losses occurred. Regardless of the type of
supraventricular tachycardia, reducing heart rate in these fetuses to
levels preventing or resolving hydrops allowed term vaginal delivery,
thereby reducing the substantial problems of ventilating an immature or
hydropic neonate.
