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CARDIAC
Year : 2000  |  Volume : 1  |  Issue : 9  |  Page : 358-364

Fetal Arrythmias


Consultant Pediatric Cardiologist, Pediatric Cardiology Section, Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation, Doha, Qatar

Correspondence Address:
Andrej Robida
Hamad Medical Corporation, P. O. Box 3050, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


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As many as 20% of referrals for fetal echocardiography is due to fetal arrhythmias. They may occur in 2% of pregnancies. Indication for echocardiographic evaluation of heart rhythm are sustained fetal heart rate below 100 beats per minute, sustained heart rates above 180 beats per minute, unexplained hydrops fetalis, and frequent and repetitive irregular heart beats. Fetuses with either sustained bradycardia or tachycardia deserve expeditious evaluation. The most important fetal bradycardia is a complete atrioventricular block, which can be associated with a structural heart disease or occur as a consequence of maternal collagen vascular disease and/ or lupus associated antibodies. Fetal therapy is difficult and often unsuccessful. The most common serious fetal tachycardia is orthodromic reciprocating atrioventricular tachycardia followed by atrial flutter. These tachycardias can be treated in utero and proposed protocols for drug management are described. A close fetal and maternal monitoring during treatment and a team approach is advised.


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