Pseudo-sinusoidal heart rate associated with major cardiac anomalies

Pseudo-sinusoidal fetal heart rate (pseudo-SHR) pattern, characterised by intermittent episodes of sinusoidal heart rate and normal fetal heart rate (FHR), is considered benign although its pathophysiologic mechanism remains obscure. We present a case of pseudo-SHR episodes throughout all stages of labor associated with multiple major cardiac anomalies. We suggest that when confronted with repeated episodes of pseudo-SHR pattern, the possibility of an underlying cardiac anomaly should be considered.