Successful treatment of atrial flutter by repeated intraperitoneal and intra-amniotic injections of amiodarone in a fetus with hydrops.

Abstract

OBJECTIVE:

We report a case of nonimmune hydrops fetalis caused by atrial flutter, which was successfully treated by intraperitoneal and intra-amniotic injections of amiodarone.

CASE REPORT:

A 27-year-old woman presented at 30 weeks of pregnancy with hydrops fetalis caused by a fetal atrial flutter. As the transplacental passage of antiarrhythmic agents is impaired in hydrops fetalis, we chose direct treatment using fetal intraperitoneal and intra-amniotic injections (75-300 mg) of amiodarone. We managed to successfully convert the fetal atrial flutter to normal sinus rhythm. The woman delivered a live female baby at 33 weeks of gestation with normal sinus rhythm and neurological development.

CONCLUSION:

Intrauterine antiarrhythmic treatment can reduce perinatal morbidity and mortality. This report suggests that direct fetal therapy using intraperitoneal or intra-amniotic injections of amiodarone constitutes an effective treatment for atrial flutter in cases of hydrops fetalis.

• Authors: Pei-Hsuan Lin, Hsin-Hung Wu, Horng-Der Tsai, Charles Tsung-Che Hsieh
• Journal: Taiwanese journal of obstetrics & gynecology (Taiwan J Obstet Gynecol) Vol. 55 Issue 3 Pg. 434-6 (Jun 2016) ISSN: 1875-6263 [Electronic] China (Republic : 1949- )
• PMID: 27343331 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2016. Published by Elsevier B.V.

Chemical References

• Anti-Arrhythmia Agents
• Amiodarone

Topics

• Adult
• Amiodarone (administration & dosage)
• Amnion
• Anti-Arrhythmia Agents (administration & dosage)
• Atrial Flutter (complications, drug therapy)
• Female
• Humans
• Hydrops Fetalis (etiology)
• Injections, Intraperitoneal
• Pregnancy