Fetal arrhythmias: Surveillance and management

Yuan, Shi‐Min

doi:10.1016/j.hjc.2018.12.003

Cited by 21 publications

(23 citation statements)

References 104 publications

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“…[28,29] Antiarrhythmic drugs such as digoxin, sotalol, and flecainide are administered alone or in combination to pregnant women with fetal supraventricular tachycardia. [30] In our study, fetal arrhythmia was present in 20 (2.3%) of 855 pregnant women with a mean gestational week of 36 (min 33-max 39). While 12 (2.3%) of 520 high-risk pregnants had fetal arrhytmia, 8 of (2.4%) of 335 low-risk pregnants had fetal arrhythmia.…”

Section: Discussionmentioning

confidence: 49%

Evaluation of the frequency and types of structural heart disease in fetuses of pregnant women according to risk groups by fetal echocardiography

Altın¹

2021

Journal of Contemporary Medicine

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Aim: The aim of this study is to evaluate the frequency of congenital heart diseases (CHD) encountered in low-risk and high-risk pregnant women by fetal echocardiographic (FE) examination. Material and Method: The records of 855 pregnant women with a gestational week greater than 16 who applied to the pediatric cardiology outpatient clinic of our hospital between July 2019- October 2021 and underwent FE were analyzed retrospectively. Results: CHD was detected in 109 (12.7%) of 855 pregnant women who were referred to our center and underwent FE examination. Frequency of CHD was given according to risk groups. The rate of CHD in patients in the high-risk group was 15.2%, while it was 9% in patients in the low-risk group (p=0.008). Significant CHD was 6.2% in the high-risk group versus 2.7% in the low-risk group (p=0.016). The most common structural cardiac anomaly in FE examination was ventricular septal defect (38.5% in 42 fetuses), and the second most common cardiac anomaly was atriyoventricular septal defect (18.3% in 20 fetuses). Conclusion: In our study, it was found a higher rate of CHD in pregnant women in the high-risk group than in the low-risk group and especially significant CHD was detected more common in pregnant women in the high-risk group.

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Section: Discussionmentioning

confidence: 49%

Evaluation of the frequency and types of structural heart disease in fetuses of pregnant women according to risk groups by fetal echocardiography

Altın¹

2021

Journal of Contemporary Medicine

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“…This case may be a new and rare association between betacoronaviruses and fetal arrhythmias in general. Fetal SVT is one of the most common fetal arrhythmias resulting in fetal heart rates over 200 bpm [ 13 ]. SVT is often caused by reentrant tachycardia, thought to be initiated through a spontaneous premature atrial complex (PAC) as well as a response to maternal or fetal infection [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Persistent Fetal SVT in a COVID-19 Positive Pregnancy

Wang

Stapley

Peterson³

et al. 2022

Case Reports in Obstetrics and Gynecology

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Background. Rapid introduction and spread of SARS-CoV-2 have posed unique challenges in understanding the disease, role in vertical transmission, and in developing management. We present a case of a patient with COVID-19 infection and fetus with new-onset fetal SVT. Case. A 26-year-old gravida 4 para 2012 with third trimester COVID-19 infection was diagnosed with new onset fetal SVT. Successful cardioversion was achieved with flecainide. The patient was followed outpatient until induction of labor at 39 and 3/7 weeks of gestational age resulting in an uncomplicated vaginal delivery. Postpartum course was uncomplicated. Conclusion. Fetal SVT is a potential complication of maternal COVID-19 infection. The use of transplacental therapy with flecainide is an appropriate alternative to digoxin in these cases.

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“…In some recent studies CHB only developed in a small proportion of anti-Ro-positive pregnancies, with various outcomes ( 4 ). Given the low penetrance, it appears reasonable that other risk factors may affect the autoimmune damage to the fetal heart conduction system, such as genetic background variants and placental dysfunction.…”

Section: Pathogenesismentioning

confidence: 99%

“…Approaches to CHB management are still controversial, and decisions are always made based on the advantages and disadvantages of administration. Emerging evidence suggests that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses, and some common opinions pertaining to the prenatal management of CHB have emerged ( 1 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Prenatal Management Strategy for Immune-Associated Congenital Heart Block in Fetuses

Liao

Tang

Qiao

et al. 2021

Front. Cardiovasc. Med.

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Fetal congenital heart block (CHB) is the most commonly observed type of fetal bradycardia, and is potentially life-threatening. More than 50% of cases of bradycardia are associated with maternal autoimmunity, and these are collectively termed immune-associated bradycardia. Several methods have been used to achieve reliable prenatal diagnoses of CHB. Emerging data and opinions on pathogenesis, prenatal diagnosis, fetal intervention, and the prognosis of fetal immune-associated CHB provide clues for generating a practical protocol for clinical management. The prognosis of fetal immune-associated bradycardia is based on the severity of heart blocks. Morbidity and mortality can occur in severe cases, thus hieratical management is essential in such cases. In this review, we mainly focus on optimal strategies pertaining to autoimmune antibodies related to CHB, although the approaches for managing autoimmune-mediated CHB are still controversial, particularly with regard to whether fetuses benefit from transplacental medication administration. To date there is still no accessible clinical strategy for autoimmune-mediated CHB. This review first discusses integrated prenatal management strategies for the condition. It then provides some advice for clinicians involved in management of fetal cardiovascular disorder.

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Fetal arrhythmias: Surveillance and management

Cited by 21 publications

References 104 publications

Evaluation of the frequency and types of structural heart disease in fetuses of pregnant women according to risk groups by fetal echocardiography

Evaluation of the frequency and types of structural heart disease in fetuses of pregnant women according to risk groups by fetal echocardiography

Persistent Fetal SVT in a COVID-19 Positive Pregnancy

Prenatal Management Strategy for Immune-Associated Congenital Heart Block in Fetuses

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