[Fetal arrhythmia--own experience].
Experience in diagnosis and treatment of fetal arrhythmia of Prenatal Cardiology Clinic in the Children's Memorial Health Institute (until 2001), and then the Perinatology and Perinatal Cardiology Clinic of the 2nd Department of Obstetrics and Gynecology in the Medical University of Warsaw are discussed. The author described physiology and pathophysiology of the fetal conduction system, diagnostic and therapeutic methods of fetal arrhythmia. We retrospectively analyzed 130 fetuses with arrhythmia. Median time of diagnosis was 30 weeks, median maternal age 28 years. Extrasystole was the most common type of fetal arrhythmia (83 fetuses). 19 of them had to be closely followed up, because there were structural anomalies in 6 (7.2%) of them, and progression of arrhythmia (bradycardia, supraventricular tachycardia or atrial flutter) in 17. Supraventricular tachycardia was diagnosed in 17 fetuses (12--SVT, 5--atrial flutter AF), and all of them were treated in utero. Transplacental therapy with digoxin, flecainide, sotalol and amiodarone was used, and transumbilical emergency treatment with adenosine was introduced in 2 fetuses with severe hydrops. Complete heart block (CHB) was in 12 fetuses, in 8 with severe heart defects, in 4 was caused by anti-Ro antibodies. We concluded that extrasystole, although in majority were benign condition, in 15% fetuses needed to be followed up, due to heart defect or more serious arrhythmia. Type of rhythm disturbances can change during pregnancy. SVT and AF could be successfully treated transplacentally. All cases with CHB and heart defect died in utero or shortly after birth. Follow up of fetuses with CHB without heart defect seemed to be much better.
Szymkiewicz-Dangel
Joanna
J
II Katedra i Klinika Połoznictwa i Ginekologii, Akademii Medycznej w Warszawie, Szpital Kliniczny im. Ksieznej Anny Mazowieckiej. dangel@dan.neostrada.pl
D000293:Adolescent; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D046128:Fetal Therapies; D005865:Gestational Age; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
D000889:Anti-Arrhythmia Agents