[Analysis of mode of delivery in cases with fetal premature atrial contractions].
OBJECTIVE
Premature atrial contractions are common in obstetrical practise but there is little information available on recommended management and mode of delivery.


METHODS
The aim of the study was to describe our clinical experience in the management of fetal arrhythmia including the indications for certain time and way of labour.


METHODS
128 fetuses with diagnosed supraventricular arrhythmia described as atrial extrasystole were examined. They were divided into 3 main groups: group I (84 fetuses) with single PAC, group II (37 fetuses) with quantitatively significant arrhythmia or accompanied by another kind of arrhythmia and group III (7 fetuses) associated with extracardiac abnormalities.


RESULTS
Among 128 fetuses with supraventricular arrhythmia, 44 cases (31%) required systematic monitoring. Quantitatively significant arrhythmia was recognized in 15 cases, blocked bigeminy (2:1) in 2 fetuses, 10 cases were accompanied by another arrhythmias: 4x SVT, 4x sinus bradycardia, 2x premature ventricular contractions (PVC). There were 3 fetuses diagnosed with heart defects and 7 with extracardiac malformations. Fetal echocardiography revealed additional functional circulatory changes in 7 fetuses with premature atrial contractions. Myocarditis was recognized in 2 fetuses. The mode of delivery was analyzed in 128 cases. In the first group 27 patients (32%) underwent caesarean section, in the second group--23 (62%), in the third group 3 patients (43%), respectively. Cardiac indications for caesarean section equalled 22% of all the indications occurring in fetuses suffering from arrhythmia.


CONCLUSIONS
Caesarean section is much more commonly performed among fetuses diagnosed with arrhythmia accompanied by another fetal anomalies comparing to the group of fetuses with isolated arrhythmia. Although there are no particular cardiac indications for such way of delivery, total amount of caesarean sections performed in that group is really great. Above all, it may suggest that the obstetrician is under pressure of stress while making decision concerning caesarean section performance, even when there are no other indications and the condition of fetus is stable enough.
Włoch
Stanisław
S
III Katedry i Kliniki Połoznictwa i Ginekologii SlAM w Katowicach.
Włoch
Agata
A
Sikora
Jerzy
J
Wilk
Krzysztof
K
Wegrzyn
Piotr
P
Szydłowski
Lesław
L
Kamiński
Kazimierz
K
Respondek-Liberska
Maria
M
D000328:Adult; D018880:Atrial Premature Complexes / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006330:Heart Defects, Congenital / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D016216:Ultrasonography, Prenatal