Evaluation of Transplacental Treatment for Fetal Congenital Bradyarrhythmia - Nationwide Survey in Japan
Evaluation of Transplacental Treatment for Fetal Congenital Bradyarrhythmia - Nationwide Survey in Japan
复制标题
DOI：
10.1253/circj.cj-11-1020
复制
发表时间：
2012-02-01
影响因子：
3.3
通讯作者：
Ikeda, Tomoaki
中科院分区：
文献类型：
--
作者：
Miyoshi, Takekazu;Maeno, Yasuki;Ikeda, Tomoaki
背景：关于胎儿先天性缓慢性心律失常的大型研究很少。本研究的目的是调查的影响和风险，经胎盘治疗这种condition.Methods和结果：使用问卷调查，128例胎儿缓慢性心律失常确定在52个日本机构从2002年至2008年。在128个胎儿中，有90个心脏结构正常。在这90个胎儿中，61个有完全性房室传导阻滞（CAVB），16个有二度AVB，8个有窦性心动过缓，5个有其他情况。将61例CAVB胎儿分为接受经胎盘药物治疗的胎儿（n=38）和未接受经胎盘药物治疗的胎儿（n=23）。单用β-拟交感神经药，类固醇单药治疗，并与这些药物的联合治疗，分别为11，5和22例。β-拟交感神经药改善了心动过缓（P <0.01），激素治疗10周后（P=0.043）。结论：β-拟交感神经药治疗改善了心动过缓，但经胎盘给药和不经胎盘给药的胎儿存活率无显著差异。建议类固醇的使用应限于
Background: There are few large studies of fetal congenital bradyarrhythmia. The aim of the present study was to investigate the effects and risks of transplacental treatment for this condition.Methods and Results: Using questionnaires, 128 cases of fetal bradyarrhythmia were identified at 52 Japanese institutions from 2002 to 2008. Of the 128 fetuses, 90 had structurally normal hearts. Among these 90 fetuses, 61 had complete atrioventricular block (CAVB), 16 had second-degree AVB, 8 had sinus bradycardia, and 5 had other conditions. The 61 CAVB fetuses were divided into those who did (n=38) and those who did not (n=23) receive transplacental medication. Monotherapy with beta-sympathomimetics, steroid monotherapy, and combination therapy with these agents was given in 11, 5 and 22 cases, respectively. Beta-sympathomimetics improved bradycardia (P10 weeks on steroids (P=0.043).Conclusions: Treatment with beta-sympathomimetics improved bradycardia, but survival rate did not differ significantly in fetuses with and without transplacental medication. It is recommended that steroid use should be limited to