Systematic Appraisal of Diagnosis and Management of Arrhythmias in the Fetus

Abstract

Fetal arrhythmias are one of the most feared clinical problems encountered during the pregnancy that require prompt recognition and effective management by a multidisciplinary team involving fetal medicine specialist, fetal cardiologist, midwife, radiologist, sonographer, neonatologist and the patient herself. This review is aimed at providing a concise guide to medical practitioners involved in the care of pregnant women and the fetus on the diagnosis and management of fetal arrhythmias, follow-up principles and delivery recommendations. How to cite this article Uzun O, Goynumer G, Sen C, Beattie B. Systematic Appraisal of Diagnosis and Management of Arrhythmias in the Fetus. Donald School J Ultrasound Obstet Gynecol 2015;9(3):314-326.

Recognition of Normal Fetal Cardiac Structures

“…In order to evaluate the heart and rhythm, an operator should acquire cardiac wall motion or flow velocity tracings via employing pulse wave Doppler, tissue Doppler, or M-mode ultrasound modalities (Fig. 3) [4]. The normal heart rate at midgestation ranges from 110 to 160 beats per minute (bpm), with no pauses, no skipped or extra beats.…”

“…Routine views of the left and the right ventricular outflow tracts are now being considered a part of routine mid-trimester cardiac screening. The evaluation of the outflow tracts substantially improves the detection rates of serious cardiac malformations [1,[4][5][6][7]. One should visualize the size, origin, position, and opening of the aorta and the pulmonary artery.…”