Maternal atrial arrhythmia detected by uterine artery Doppler

Uterine artery Doppler ultrasound assessment is used to assess uteroplacental blood flow and the risk of placental ischemic-thrombotic injury in high-risk pregnancies. We report here a case in which this examination identified the presence of a maternal atrial arrhythmia.

A 50-year-old woman with no significant past medical history received antenatal care in our fetal medicine unit clinic because of advanced maternal age, a history of recurrent pregnancy loss, multiple uterine fibroids, and a history of in vitro fertilization using donated oocytes. Uterine artery Doppler ultrasound was normal at 19 weeks, but was repeated at 33 weeks because of abnormal placental texture and maternal risks, revealing an irregular maternal heart rhythm. Paroxysmal atrial fibrillation was confirmed by Holter monitor at 34 weeks. The patient was asymptomatic and declined the cardiologist's recommendation of antepartum and postpartum anticoagulation. She remained asymptomatic and had delivery by Caesarean section at term.

Uterine artery Doppler flow studies may identify a significant maternal cardiac arrhythmia.