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THE OCCURRENCE of paroxysmal atrial tachycardia or atrial flutter in infancy is well documented and has been reviewed in previous communications.1,2 Congestive heart failure secondary to prolonged paroxysmal atrial tachycardia occurred in approximately 50% of cases in one reported series.1 Some of these patients had peripheral edema. Whereas the onset of paroxysmal atrial tachycardia during intrauterine life has been reported,3-7 our search of the literature has not disclosed the description of massive peripheral edema associated with intrauterine paroxysmal atrial tachycardia. We recently encountered an example of this phenomenon, and the uncertainties which surrounded our patient's obstetric and pediatric management prompted this report and discussion. REPORT OF A CASE A white female infant was born at University Hospitals, Iowa City, on Nov 26, 1967 to an 18-year-old girl who was normotensive, Rh factor positive, serologic negative, primigravida, delivered after an estimated 38 weeks of gestation. The mother's past

No specific hematologic defect has so far been found in this disorder, but its many similarities to blood diseases suggest that there is one. Treatment is mainly supportive, unless there is concomitant bacterial infection (which is often the case).