Sinusoidal rhythm caused by fetal hemorrhage during fetoscopy.
The sinusoidal fetal heart rate pattern has been reported to be associated with fetal anemia, hypoxia, administration of alphaprodine while, in other cases, it has been followed by good fetal outcome. In this case study fetoscopy was performed in a patient with thalassemia trait for prenatal diagnosis of thalassemia. Following the insertion of the trocar, bloodstained amniotic fluid was aspirated which resulted to be all fetal in origin. Estimation of feto-maternal hemorrhage was 5.7 ml while the amount of intra-amniotic bleeding could not be assessed. Fetal heart rate, which was recorded throughout fetoscopy, showed a sinusoidal pattern starting two minutes after the fetal hemorrhage which lasted more than ten minutes. Two hours later the fetal heart rate was normal. The pregnancy continued uneventfully and a healthy female baby weighing 3100 g was delivered at 38 weeks' gestation. Review of the literature suggests that a sinusoidal pattern may be caused either by a hemodynamic disturbance or fetal acidosis. In any case it does not always indicate impending fetal death.
D000328:Adult; D004562:Electrocardiography; D005260:Female; D005315:Fetal Diseases / Q000150:complications / Q000209:etiology*; D005318:Fetal Heart / Q000503:physiopathology*; D005332:Fetoscopy / Q000009:adverse effects*; D006329:Heart Conduction System / Q000502:physiology*; D006339:Heart Rate; D006470:Hemorrhage / Q000150:complications / Q000209:etiology*; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000009:adverse effects*