Vlagsma R, Hallensleben E, Meijboom E J
Leids Universitair Medisch Centrum, afd. Interne Geneeskunde, Leiden.
Ned Tijdschr Geneeskd. 2001 Feb 17;145(7):295-9.
Foetal arrhythmias are encountered in 1-2% of pregnancies and 10% of these are associated with some form of foetal mortality or morbidity, including structural heart disease, foetal death and neurological complications. The most frequent types of arrhythmia are supraventricular arrhythmias of which the innocent premature atrial depolarisations make up 85%; 10% are tachycardias with a foetal heart rate of over 180/min. Echocardiographic evaluation is required to exclude associated structural abnormalities and to decide whether therapy is required. The prognosis of a foetus with tachycardia depends on the presence of associated pathology, the type of arrhythmia, the presence of foetal hydrops, the heart rate and the adequacy of treatment. The treatment of foetal tachycardia depends on the type of the tachycardia and since most tachycardias are of supraventricular origin the therapeutic armamentarium includes digoxin, sotalol and flecainide, each with its specific side effects. Foetal tachycardia patients require immediate diagnosis and if necessary therapy in a specialized center.
胎儿心律失常在1%-2%的妊娠中出现，其中10%与某种形式的胎儿死亡或发病相关，包括结构性心脏病、胎儿死亡和神经并发症。最常见的心律失常类型是室上性心律失常，其中无害的房性早搏占85%；10%是胎儿心率超过180次/分钟的心动过速。需要进行超声心动图评估以排除相关的结构异常，并决定是否需要治疗。胎儿心动过速的预后取决于相关病变的存在、心律失常的类型、胎儿水肿的存在、心率以及治疗的充分性。胎儿心动过速的治疗取决于心动过速的类型，由于大多数心动过速起源于室上性，治疗药物包括地高辛、索他洛尔和氟卡尼，每种药物都有其特定的副作用。胎儿心动过速患者需要在专业中心立即诊断，必要时进行治疗。
