Related Experiment Videos
Neonatal cholestasis associated with fetal arrhythmia
Ana Maria Sant'Anna1, Jean-Claude Fouron, Fernando Alvarez
1Division of Pediatric Gastroenterology, Hepatology, and Nutrition and the Fetal Cardiology Unit, Department of Pediatrics, St. Justine Hospital, University of Montreal, Montreal, Quebec, Canada.
The Journal of Pediatrics
|February 4, 2005
Summary
Fetal arrhythmias can lead to neonatal cholestasis, particularly supraventricular tachycardia. Atrio-ventricular block poses a severe risk, while atrial flutter does not appear to cause cholestasis.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Fetal Medicine
Background:
- Neonatal cholestasis is a serious condition requiring understanding of its causes.
- Fetal arrhythmias are known to impact neonatal outcomes.
- The relationship between specific fetal arrhythmia types and neonatal cholestasis requires further elucidation.
Purpose of the Study:
- To investigate the association between different types of fetal arrhythmias and the development of neonatal cholestasis.
- To determine if specific fetal arrhythmia subtypes carry a higher risk for cholestasis.
- To analyze outcomes in neonates with fetal arrhythmias and cholestasis.
Main Methods:
- Retrospective chart review of 38 infants with sustained, hemodynamically significant fetal arrhythmias (supraventricular tachycardia, atrial flutter, atrio-ventricular block).
- Comparison of arrhythmia duration between cholestatic and non-cholestatic groups.
- Analysis of cholestasis development and outcomes based on arrhythmia type.
Main Results:
- Six out of 38 infants developed neonatal cholestasis.
- Cholestasis was more common in infants with longer durations of fetal arrhythmia (40.3 days vs. 15.7 days).
- Supraventricular tachycardia-associated cholestasis resolved; atrio-ventricular block was associated with mortality and severe liver failure; atrial flutter showed no cholestasis.
Conclusions:
- Tachyarrhythmias during fetal life can result in transient neonatal cholestasis.
- Atrio-ventricular block in fetuses carries a significant risk of severe, potentially irreversible liver failure.
- Anti-Ro antibodies may be associated with severe liver pathology (foie vide) in neonates with fetal arrhythmias.