[Prenatal diagnosis and management of fetal arrhythmias]

Reported in this paper are 25 cases of fetal arrhythmia handled at the Gynaecological Department of the Berlin School of Medicine (Charité) over a period of two years. They were subdivided by tachycardiac, bradycardiac, and simple forms, following ultrasound-assisted diagnosis (realtime, M-Mode, Doppler). This proved to be useful for better prenatal management and prognosis. The first and second forms were linked to higher rates of malformations or contributory and recordable causes, whereas the third form could be considered harmless, the more as spontaneous postnatal regression was to be expected. Successful experience is reported, as obtained from prenatal therapy either via the mother or by direct invasive treatment to the child (thigh, umbilical vein). Early referral to an adequately staffed and equipped centre and exclusion of cardiac defects are conditions for good success. Intrauterine deaths occurred in two cases due to cardiac malformations, and non-immunological fetal hydrops was established in four cases. Optimal management of the inhomogenous group of fetal arrhythmias should be undertaken in interdisciplinary teamwork at centres with experience in perinatal medicine.