title: Intrapartum fetal atrial bigeminy--diagnostic and therapeutic role of the fetal scalp stimulation test.
abstract: Concern for fetal hypoxia often leads to cesarean delivery when persistent fetal bradycardia is identified. A fetus with premature atrial contractions had a prolonged second-stage heart rate of 80 beats/min. Intrapartum echocardiography and electronic fetal heart rate monitoring distinguished bradycardia caused by blocked atrial bigeminy from hypoxic bradycardia. The fetal scalp stimulation test documented normal acid-base balance and normalized the ventricular rate, avoiding cesarean delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, Virginia, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Wax
authors.forename: M
authors.initials: M
authors.lastname: Emmerich
authors.forename: M K
authors.initials: MK
authors.lastname: Eggleston
mesh_terms: D000328:Adult; D018880:Atrial Premature Complexes / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D001919:Bradycardia / Q000209:etiology; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000628:therapy*; D005323:Fetal Monitoring; D005333:Fetus / Q000502:physiology; D006340:Heart Rate, Fetal; D006801:Humans; D007743:Labor, Obstetric; D010812:Physical Stimulation; D011247:Pregnancy; D012535:Scalp / Q000196:embryology*; D016216:Ultrasonography, Prenatal