The Treatment of Fetal Supraventricular Tachycardia: A Case Report and Literature Review

Fetal supraventricular tachycardia (SVT), as the most common fetal tachyarrhythmia, can lead to serious complications such as decreased cardiac output, ascites, pleural or pericardial effusion, skin edema, and even fetal hydrops in specific cases, marking the severe stage of fetal congestive heart failure. Hydrops significantly increases infant mortality. Therefore, timely treatment and restoration of normal fetal heart rate are essential for fetal survival and full-term delivery. Based on clinical cases, this article discusses the current situation of fetal SVT treatment and individual differences, as well as the strategy of fetal drug conservative treatment and the best time to terminate pregnancy. Here we report a case of supraventricular tachycardia diagnosed by fetal heart rate monitoring at 29 weeks and 2 days of gestation. The results of fetal heart ultrasound and Doppler monitoring showed that the fetus had the possibility of cardiac insufficiency and fetal intracranial hydrops, and the fetal heart rate returned to normal after oral treatment with digoxin and sotalol. The pregnancy was terminated by cesarean section at 36 weeks and 5 days of gestation because of recurrent supraventricular tachycardia, reverse a wave of venous catheter and oligohydramnios. The newborn weighed 3035 grams. No arrhythmia was found in the follow-up of pregnant women and newborns. Fetal supraventricular tachycardia does not necessarily terminate pregnancy. In fact, most of these fetuses have a good prognosis after conservative treatment in utero. The treatment plan should take into account the gestational age, the specific conditions of the fetus and the mother. The purpose of this article is to review the diagnosis and treatment process of this case and provide valuable reference for clinical practice.