Prenatal diagnosis and treatment of fetal long QT syndrome: a case report |
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Authors: | Ing-Kuang Chang Ming-Kwang Shyu Chien-Nan Lee Miau-Ling Kau Yu-Hsueh Ko Song-Nan Chow Fon-Jou Hsieh |
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Affiliation: | Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China |
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Abstract: | We report a case of a fetus presenting with bradycardia, intermittent atrioventricular (AV) block, ventricular tachycardia (VT) and the signs of fetal congestive heart failure (ascites and scrotal hydrocele) during mid-gestation. Prenatal treatment with β-adrenergic blocker (propranolol) and digitalis glycosides was prescribed because of suspicion of long QT syndrome occurring with fetal congestive heart failure. The male baby was born at 39 weeks of gestation and showed a prolonged QT interval (QTc = 492 ms) and frequent variable AV block or alternating left and right bundle branch block, depending on the atrial rate. Prenatal administration of lidocaine failed to correct the fetal VT. Conversely, propranolol decreased the attack frequency of fetal VT. Postnatal administration of the K+ channel opener (nicorandil) successfully shortened the QT interval and improved the outcome. Copyright © 2002 John Wiley & Sons, Ltd. |
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Keywords: | long QT syndrome prenatal diagnosis prenatal treatment ventricular tachycardia congestive heart failure |
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