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Clinical Outcome and Circulatory Effects of Fetal Cardiac Arrhythmia
Author(s) -
LINGMAN G.,
LUNDSTRÖM N.R.,
MARŠÁL K.
Publication year - 1986
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1986.tb10398.x
Subject(s) - medicine , cardiology , premature atrial contraction , fetal distress , fetus , heart failure , circulatory system , digoxin , bradycardia , anesthesia , heart rate , atrial fibrillation , pregnancy , blood pressure , biology , genetics
. By means of abdominal fetal ECG and non‐invasive ultrasound blood flow studies 113 cases of fetal cardiac arrhythmia were classified according to the origin of arrhythmia. Pregnancy outcome was characterized by an increased frequency of fetal distress and heart malformation, and increased fetal and neonatal mortality. The following types of arrhythmia were identified: supraventricular extrasystoles ( n =84), paroxysmal tachycardia ( n =6), sinus bradycardia ( n =3), atrial flutter ( n =1), ventricular extrasystolw ( n =14), and atrioventricular block ( n =5). In 37 cases the combined Doppler and real‐time ultrasound tehnique was used to measure fetal aortic blood flow as a means of studying the circulatory effects of the arrhythmia. Increased peak velocity, risiig slope and acceleration were found in the first post‐pausal beat after a supraventricular extrasystole or a missed beat; this supports the validity of Frank‐Starling law for the fetal heart and suggests that a strong relationship exists between these variables and myocardial contractility, In two cases of intra‐uterine heart failure, the effect of digoxin treatment in utero on the fetal aortic flow variables was studied, results indicating a positive inotropic effect of the drug on the fetal myocardium. The estimation of fetal aortic volume blood flow in cases of fetal cardiac arrhythmia is useful for early detection of fetal cardiac failure, and for monitoring the effects of intra‐uterine treatment.