[Application of fetal echocardiography in detection of fetal arrhythmia and its clinical significance].
OBJECTIVE
To investigate application of fetal echocardiography in diagnosis of fetal arrhythmia and its clinical significance.


METHODS
Fetal echocardiography was performed on 725 fetuses for evaluation of fetal heart structures and arrhythmias. Two-dimensional, M-mode, Color M-mode and pulsed Doppler echocardiography were used.


RESULTS
Ninety fetuses were documented with fetal arrhythmia, the commonest fetal arrhythmia encountered in 72 cases extrasystole was (65 atrial extrasystoles, 7 ventricular extrasystoles), followed by bradycardia in 9 cases, tachycardia in 6 cases, 2:1 atrioventricular block in 2 cases, atrial flutter in 1 case. There were 4 fetuses with arrhythmias and structural heart diseases: 2 fetuses were found died in uterus within two-week follow-up (1 with single ventricle and pulmonary stenosis, 1 with cardiac rhabdomyoma, fetal echocardiographic findings were confirmed at autopsy), another 2 cases (1 with mitral atresia and 1 with atrioventricular canal defect, autopsy confirmed the fetal echocardiographic diagnoses) received termination of pregnancy later. One 38-week fetus with atrial flutter underwent cesarean section, neonatal ECG confirmed the arrhythmia, and Cedilanid D induced successful conversion. All the other 85 fetuses were with intermittent arrhythmia, normal heart structures, and had no fetal hydrops. After receiving routine treatment, all of them had term deliveries and follow-up monitoring showed normal neonatal heart rhythms (auscultation).


CONCLUSIONS
Fetal echocardiography is the main diagnostic tool for prenatal evaluation of fetal arrhythmias. The outcomes of the vast majority of fetal arrhythmias are benign, especially for fetuses with extrasystoles. Their arrhythmias are always well tolerated and disappear during the perinatal period. Fetuses with intermittent arrhythmias without structural heart malformations, fetal hydrops or heart failure, can be followed up with routine prenatal care without the need for special intervention.
Department of Diagnostic Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, China.
Bo-wen
BW
Zhao
Mei
M
Pan
Song-ying
SY
Zhang
Yi-li
YL
Song
Hai-shan
HS
Xu
Jin-duo
JD
Shou
Jiang-hong
JH
Lü
Sha
S
Lin
Hai-lin
HL
Tang
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging*; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D016216:Ultrasonography, Prenatal