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Diagnosis and Management of Fetal Bradyarrhythmias
Author(s) -
JAEGGI EDGAR T.,
FRIEDBERG MARK K.
Publication year - 2008
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2008.00957.x
Subject(s) - medicine , bradycardia , fetus , cardiology , atrioventricular block , fetal echocardiography , concomitant , sinus bradycardia , anesthesia , gestation , heart rate , pregnancy , prenatal diagnosis , blood pressure , biology , genetics
Complete atrioventricular block (CAVB) is the most common cause of persistent fetal bradycardia. In the presence of a structurally normal heart, it develops primarily in anti‐Ro and anti‐La positive antibody pregnancies after 20 weeks of gestation. There is a significant risk of perinatal demise, particularly in association with fetal hydrops, poor ventricular function, and heart rates < 55 beats/min. Transplacental treatment strategies are aimed at preventing or modulating these risk factors. Maternal administration of dexamethasone to mitigate or prevent concomitant myocardial inflammation, in combination with β‐stimulation for persistent fetal bradycardia < 55 beats/min to increase fetal cardiac output, has resulted in significantly improved fetal and neonatal outcomes without reversing CAVB.