[Paroxysmal junctional reciprocal tachycardia and fetoplacental anasarca]

Foeto-placental anasarca was diagnosed at 34 weeks gestation in a patient with acute hydramnios. Foetal tachycardia at 300 bpm was recorded. This obstetrical problem led to the birth of a premature baby with generalised oedema, for which the only apparent cause was the tachycardia. This was identified as a paroxysmal junctional reciprocating tachycardia, initiating on atrial extrasystolic echos, terminating on R waves, with lengthening of the PR interval at the onset of tachycardia, without acceleration of the sinus rate and P'R = RP'. Paroxysmal junctional reciprocating tachycardia in utero was responsible for congestive cardiac failure and foeto-placental anasarca. The cardiac failure was treated by foetal delivery, artificial respiration and digoxin. The association of digoxin-disopyramide reduces the frequency of attacks of tachycardia and treatment may be stopped after one year's follow-up.