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Fetal arrhythmias: natural history and management

Patrizia Vergani1, Eloisa Mariani, Elena Ciriello

  • 1Department of Obstetrics and Gynecology, University of Milano-Bicocca, Monza, Italy. pvergani@yahoo.it

Ultrasound in Medicine & Biology
|January 18, 2005
PubMed

Insights

Fetal arrhythmias detected via prenatal ultrasound screening have a 0.3% incidence. While most fetal tachyarrhythmias have a good prognosis, bradyarrhythmias are less favorable, with survival dependent on type and associated anomalies.

Area of Science:

  • Cardiology
  • Prenatal Medicine
  • Pediatrics

Background:

  • Fetal arrhythmias are detected during prenatal screening.
  • Understanding their natural history and management is crucial.

Purpose of the Study:

  • To delineate the significance and natural history of fetal arrhythmias.
  • To provide information on the management of fetal arrhythmias.
  • To assess outcomes of fetuses with arrhythmias.

Main Methods:

  • A cohort of 114 infants with fetal arrhythmias identified via prenatal ultrasound.
  • Echocardiography and clinically indicated treatment were administered.
  • Postnatal outcomes were tracked for 1 year.

Main Results:

  • The incidence of fetal arrhythmias was 0.3%.
  • Atrial extrasystoles led to supraventricular tachycardia (SVT) in 2.3% of fetuses.
  • In utero antiarrhythmic therapy (digoxin, propafenone) successfully restored sinus rhythm in 100% of SVT cases.
  • Sinus bradycardia was linked to structural anomalies; only 2 of 4 fetuses with atrioventricular block survived.

Conclusions:

  • Prognosis for most fetal tachyarrhythmias is favorable.
  • Bradyarrhythmias, particularly atrioventricular block, carry a less favorable prognosis.
  • Early detection and management of fetal arrhythmias are vital for improved outcomes.

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