Hepatic venous Doppler in the evaluation of fetal extrasystoles

Saemundsson, Ymir; Johansson, Charlotte; Wenling, Sun; Gudmundsson, Sæmundur

doi:10.1002/uog.7684

Cited by 12 publications

(33 citation statements)

References 20 publications

(24 reference statements)

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“…Significantly larger retrograde flow waves are seen during the premature atrial contraction, which is probably explained by the fact that the ventricles are not yet relaxed or are still in systole with closed AV valves . The venous α‐wave becoming larger after a longer diastolic filling period and significantly taller when atrial and ventricular contractions are synchronous, is something that has also been described by other investigators (Figure b,d,f).…”

Section: Irregular Ventricular Rhythmssupporting

confidence: 77%

Hemodynamics in fetal arrhythmia

Sonesson

Acharya

2015

Acta Obstet Gynecol Scand

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Fetal arrhythmias are among the few conditions that can be managed in utero. However, accurate diagnosis is essential for appropriate management. Ultrasound-based imaging methods can be used to study fetal heart structure and function noninvasively and help to understand fetal cardiovascular pathophysiology, and they remain the mainstay of evaluating fetuses with arrhythmias in clinical settings. Hemodynamic evaluation using Doppler echocardiography allows the elucidation of the electrophysiological mechanism and helps to make an accurate diagnosis. It can also be used as a tool to understand fetal cardiac pathophysiology, for assessing fetal condition and monitoring the effect of antiarrhythmic treatment. This narrative review describes Doppler techniques that are useful for evaluating fetal cardiac rhythms to refine diagnosis and provides an overview of hemodynamic changes observed in different types of fetal arrhythmia.

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Section: Irregular Ventricular Rhythmssupporting

confidence: 77%

Hemodynamics in fetal arrhythmia

Sonesson

Acharya

2015

Acta Obstet Gynecol Scand

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“…Although the origin of the fetal premature atrial contraction was unclear, this condition spontaneously resolved, as is often the case, and did not appear to have any detrimental effects either during pregnancy or during the neonatal period [10,14]. On the other hand, the maternal electrocardiography findings were unaltered regardless of the magnesium levels.…”

Section: Discussionmentioning

confidence: 68%

Magnesium sulfate‐induced blocked premature atrial contractions resulting in fetal bradyarrhythmia

Miyoshi

Shimizu

Noda

et al. 2013

Journal of Arrhythmia

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a b s t r a c tHere, we present a rare case of fetal bradyarrhythmia following magnesium sulfate therapy for preterm labor. After we switched treatment from ritodrine hydrochloride to magnesium sulfate at 25 weeks' gestation, the fetal heart rate dropped from 150 bpm to 80-100 bpm. Fetal echocardiography and magnetocardiography indicated bigeminy and trigeminy of blocked premature atrial contractions. It is well known that magnesium sulfate decreases the baseline and variability of fetal heart rate. Studies have reported a substantial decrease of 2-15 bpm in the baseline fetal heart rate, and magnesium has various effects on fetal heart rate patterns with a lower baseline fetal heart rate within the normal range of 110-160 bpm. This is the first report of magnesium sulfate-induced fetal bradyarrhythmia by prolongation of the refractory period of the atrioventricular node in the case of blocked premature atrial contractions. Clinicians should consider fetal bradyarrhythmia when the baseline fetal heart rate drops to o100 bpm after magnesium sulfate administration.

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“…Fetal hepatic venous Doppler was reported to be useful for the evaluation and diagnosis of fetal extrasystoles. 16 An optimal angle of insonation is nearly always obtained for HVs because of the multiplicity and different orientations of these vessels in the liver, allowing a wide …”

Section: Dual Doppler Techniquementioning

confidence: 99%

“…16 Although, PVCs can potentially progress to ventricular tachycardia, fetal ventricular tachycardia is rarely observed. Serial prenatal assessment and further evaluation after birth is essential to confirm the nature of the ectopy and to exclude intermittent runs of more sinister ventricular tachycardia.…”

Section: 1819mentioning

confidence: 99%

Fetal Dual Doppler Echocardiography

Kaji¹,

Maeda²,

Hichijo³

et al. 2014

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Dual Doppler echocardiography is a recently developed technique performed using an instrument with two separate sample gates, allowing simultaneous recording of signals from two locations. We describe the use of dual Doppler echo cardiography to assess fetal cardiac rhythm. Fetal arrhythmias are common and encountered in 1 to 2% pregnancies. They often resolve spontaneously and do not require treatment, but sometimes lead to severe morbidity and mortality. Fetal arrhythmias are responsive to fetal therapy and require appro priate management through accurate diagnosis. Pulsed wave Doppler and Mmode echocardiography are widely used to assess fetal cardiac rhythm. Both methods have advantages and limitations, which are influenced by fetal position, image resolution, and the complexity of the arrhythmia. We developed a new technique that records pulsed wave Doppler signals in the hepatic vein (HV) and the descending aorta (DAo) simultaneously using dual Doppler. This method is less influenced by fetal position and the complexity of the arrhythmia, and the images have better resolution than those acquired using conventional Doppler methods in most cases. Although, electrical parameters, such as the QT interval cannot be evaluated, dual Doppler recording of flows in HV and DAo is an efficient and effective method for assessing fetal cardiac rhythms, allowing precise diagnosis of cardiac arrhythmias.

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Hepatic venous Doppler in the evaluation of fetal extrasystoles

Abstract: Objectives

Cited by 12 publications

References 20 publications

Hemodynamics in fetal arrhythmia

Hemodynamics in fetal arrhythmia

Magnesium sulfate‐induced blocked premature atrial contractions resulting in fetal bradyarrhythmia

Fetal Dual Doppler Echocardiography

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