Am J Perinatol 2014; 31(07): 617-628
DOI: 10.1055/s-0034-1372430
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Treatment of Fetal Arrhythmia

Annette Wacker-Gussmann
1  Department of Neonatology, University Children's Hospital, Tuebingen, Germany
,
Janette F. Strasburger
2  Division of Cardiology, Department of Pediatrics, Children's Hospital of Wisconsin-Milwaukee and Fox Valley, Milwaukee, Wisconsin
,
Bettina F. Cuneo
3  Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado, Denver, Colorado
,
Ronald T. Wakai
4  Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
› Author Affiliations
Further Information

Publication History

07 January 2014

10 February 2014

Publication Date:
23 May 2014 (eFirst)

Abstract

Aims Detection and careful stratification of fetal heart rate (FHR) is extremely important in all pregnancies. The most lethal cardiac rhythm disturbances occur during apparently normal pregnancies where FHR and rhythm are regular and within normal or low-normal ranges. These hidden depolarization and repolarization abnormalities, associated with genetic ion channelopathies cannot be detected by echocardiography, and may be responsible for up to 10% of unexplained fetal demise, prompting a need for newer and better fetal diagnostic techniques. Other manifest fetal arrhythmias such as premature beats, tachycardia, and bradycardia are commonly recognized.

Methods Heart rhythm diagnosis in obstetrical practice is usually made by M-mode and pulsed Doppler fetal echocardiography, but not all fetal cardiac time intervals are captured by echocardiographic methods.

Results and Conclusions This article reviews different types of fetal arrhythmias, their presentation and treatment strategies, and gives an overview of the present and future diagnostic techniques.