2009, Number 12
<< Back Next >>
Ginecol Obstet Mex 2009; 77 (12)
Fetal cardiac rhabdomyoma as a rare cause of hydrops fetalis. A report of a case
Gayón VE, López CC, Carrera GJE
Language: Spanish
References: 11
Page: 583-588
PDF size: 521.55 Kb.
ABSTRACT
Cardiac tumors are rare entities at any age. The reported incidence in fetal echocardiograms is 0.17%. This case report presents the detection of a cardiac rhabdomyoma in a 27.5 weeks of gestational age (WGA) fetus during a routine sonogram. Treatment with terbutaline, as a cardiac inotropic and chronotropic agent, was started because of fetal bradichardia of 86 beats per minute, as well as fetal lung maturity inductors. At 30 WGA furosemide was added because of fetal
hydrops. At 32 WGA a cesarean section was performed. The fetal development at the time of birth was in accordance to the gestational age, the newborn weight was 1,820 g and the Apgar score was 1-0, at one and five minutes after delivery. The newborn died immediately after the interruption of the umbilical circulation, because of a 90% obstruction of the left ventricular cavity caused by the tumor. The present case is an evidence of the utility of a medical treatment in a severely ill fetus, that allowed it to continue with its normal development for four weeks after the diagnosis and opens the possibility for fetal medical therapy in the future for similar cases.
REFERENCES
Reynen K. Frequency of primary tumors of the heart. Am J Cardiol 1996;77:107.
Arnaiz P, Toledo I, Borzutzky A, Urcelay G y col. Comportamiento clínico de los tumores cardiacos desde el feto hasta el adulto. Rev Med Chile 2006;134:1135-45.
Ibrahim CPH, Thakker P, Miller PA, Barron D. Cardiac rhabdomyoma presenting as left ventricular outflow tract obstruction in a neonate. Interact Cardiovasc Thorac Surg 2003;2:572-4.
Norma Oficial Mexicana NOM-007 SSA2-1993, Atención de la mujer durante el embarazo, parto y puerperio y del recién nacido. Criterios y procedimientos para la prestación del servicio.
Lethor JP, De Moor M. Multiple cardiac tumors in the fetus. Circulation 2001;103:e55.
Uzyn O, McGawley G, Wharton GA. Multiple cardiac rhabdomyomas: tuberos sclerosis or not. Heart 997;77:388.
Rashid NA, Sharma J. Picture of the month. Arch Pediatr Adoles Med 2001;155:962.
Geva T, Santini F, Pear W, Driscoll SG, Van Praagh R. Cardiac rhabdomyoma. Rare cause of fetal death. Chest 1991;99:139-43.
Veldtman GR, Blackburn MEC, Wharton GA, daCosta P, Gibbs JL. Dystropic calcification of the fetal myocardium. Heart 1999;81:92-93.
Nakata M, Fujiwara M, Ishikawa Y, Sumie M, et al. Prenatal diagnosis and management for a large fetal cardiac tumor complicated with hydrops fetalis. J Obstet Gynecol Res 2005;31(5):476-9.
Chao AS, Chao A, Wang TH, Chang YC, et al. Outcome of antenatally diagnosed cardiac rhabdomyoma: case series and metaanalysis. Ultrasound Obstet Gynecol 2008;31(3):289-95.