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March 1986, Vol 140, No. 3 >
Article | March 1986

Cardiac Therapeutic Implications From Fetal Echocardiography FREE

RICHARD L. DONNERSTEIN, MD; HUGH D. ALLEN, MD
Am J Dis Child. 1986;140(3):198. doi:10.1001/archpedi.1986.02140170024018.
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The article by Wiggins et al1 in this month's AJDC raises several important issues regarding the treatment of fetal heart problems. Besides demonstrating that fetal supraventricular tachyarrhythmias are treatable, they have provided evidence that congestive heart failure from other causes may respond to in utero therapy. Fetal echocardiography, until recently only a research tool, has now become a standard procedure for the evaluation of a fetus with suspected cardiac anomaly or dysrhythmia.2 The diagnosis of "idiopathic" fetal hydrops has become less tenable with present technology,3 and prompt, thorough evaluation of all such patients is indicated. Many cases of fetal hydrops are secondary to cardiac dysrhythmias or structural defects, and if left untreated, are associated with a very high rate of mortality.

REFERENCES

1 +
Wiggins JW Jr, Bowes W, Clewell W, et al:  Echocardiographic diagnosis and intravenous digoxin management of fetal tachyarrhythmias and congestive heart failure . AJDC 1986;;140: 202-204.
2 +
Kleinman CS, Donnerstein RL, Jaffe CC, et al:  Fetal echocardiography: A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: Analysis of 71 patients . Am J Cardiol 1983;;51:237-243.
3 +
Kleinman CS, Donnerstein RL, DeVore GR, et al:  Fetal echocardiography for evaluation of in utero congestive heart failure . N Engl J Med 1982;;306:568-575.
4 +
Kleinman CS, Copel JA, Weinstein EM, et al:  In utero diagnosis and treatment of fetal supraventricular tachycardia . Semin Perinatol 1985;;9:113-129.
5 +
Bergmans MGM, Jonker GJ, Kock HCLV:  Fetal supraventricular tachycardia: Review of the literature . Obstet Gynecol Surv 1985;;40: 61-68.
6 +
Graves SW, Valdes R, Brown BA, et al:  Endogenous digoxin-immunoreactive substance in human pregnancies . J Clin Endocrinol Metabol 1984;;58:748-751.
7 +
Simpson PC, Trudinger BJ, Walker A, et al:  The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac, acephalic monster . Am J Obstet Gynecol 1983;;147:842-844.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Wiggins JW Jr, Bowes W, Clewell W, et al:  Echocardiographic diagnosis and intravenous digoxin management of fetal tachyarrhythmias and congestive heart failure . AJDC 1986;;140: 202-204.
2 +
Kleinman CS, Donnerstein RL, Jaffe CC, et al:  Fetal echocardiography: A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: Analysis of 71 patients . Am J Cardiol 1983;;51:237-243.
3 +
Kleinman CS, Donnerstein RL, DeVore GR, et al:  Fetal echocardiography for evaluation of in utero congestive heart failure . N Engl J Med 1982;;306:568-575.
4 +
Kleinman CS, Copel JA, Weinstein EM, et al:  In utero diagnosis and treatment of fetal supraventricular tachycardia . Semin Perinatol 1985;;9:113-129.
5 +
Bergmans MGM, Jonker GJ, Kock HCLV:  Fetal supraventricular tachycardia: Review of the literature . Obstet Gynecol Surv 1985;;40: 61-68.
6 +
Graves SW, Valdes R, Brown BA, et al:  Endogenous digoxin-immunoreactive substance in human pregnancies . J Clin Endocrinol Metabol 1984;;58:748-751.
7 +
Simpson PC, Trudinger BJ, Walker A, et al:  The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac, acephalic monster . Am J Obstet Gynecol 1983;;147:842-844.

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