Revista de Pesquisa de Pediatria Clínica

Fetal Tachycardia as Neonatal Atrial Flutter in Infant of Diabetic Mother (IDM): A Case Report

Sobaih BH and Hussain SA

Atrial flutter (AF) is defined a rapid regular atrial rate of 300-600 bpm accompanied by variable degrees of atrioventricular (AV) conduction block. This  is rare in fetuses and neonates. Fetuses and neonates with atrial flutter or ectopic atrial tachycardia were more likely to be macrosomic or born to diabetic mothers than the general population. Postnatal echocardiography suggests that there may be abnormal diastolic left ventricular filling in some babies with these arrhythmias. Fetal AF is a serious and threatening rhythm disorder; particularly when it causes hydrops, it may be associated with fetal death or neurological damage. The risk of sudden death from 20 to 40 weeks of gestation is 6 to 12 deaths /1000 fetuses per year. Treatment is primarily aimed at reaching an adequate ventricular rate and preferably conversion to sinus rhythm. Prompt recognition of the arrhythmia and initiation of adequate therapy will be lifesaving. Here we reported a full term baby girl who was born by emergency cesarean section based on fetal tachycardia which persisted after birth. Postnatal cardiac evaluation revealed evidence of AF which was eventually converted to normal sinus rhythm by the use of Amiodarone after failure of 3 doses of Adenosine.