Fetal Arrhythmia

JOURNAL TITLE: Donald School Journal of Ultrasound in Obstetrics and Gynecology

Author
1. Ana Bianchi
ISSN
0973-614X
DOI
10.5005/jp-journals-10009-1553
Volume
12
Issue
1
Publishing Year
2018
Pages
3
Author Affiliations
    1. Department of Prenatal Medicine (UMP), Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
  • Article keywords
    Arrhythmia, Atrial fibrillation, Paroxysmal supraventricular tachycardia.

    Abstract

    The normal cardiac frequency of the fetus is between 120 and 160 bpm. Fetal arrhythmia happens in 1 to 2% of pregnancies. Most of them are beginning with spontaneous solution. Less than 10% implies a real problem, such as fetal hydrops and fetal death. The evaluation of the cardiac rhythm is usually done by two methods: M mode and Doppler. Each method has its advantages and limitations. It is important for the physician to be aware of the etiology, development, and natural history of these arrhythmias, and the diagnostic and therapeutic options available. A simultaneous record of both ventricular and atrial contractions with a four-chamber view is useful for assessing the relation of atrioventricular (AV) connection in fetuses with arrhythmias. We will present different types of arrhythmias: tachycardia, bradycardia, irregular rhythm, paroxysmal supraventricular tachycardia (PSVT), atrial fibrillation (AFL). Fetal bradycardia is mainly due to AV block. Half of all cases are caused by associated congenital heart disease (CHD), or by maternal SS-A antibodies. Efficacy of prenatal treatment for fetal AV block is limited. Most fetuses with both PSVT and atrial flutter are successfully treated by transplacental administration of antiarrhythmic drugs. Digoxin is widely accepted as a first-line antiarrhythmic drug. Sotalol, flecainide, and amiodarone are used as second-line drugs.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved