Wong S F, Chau K T, Ho L C
Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong.
Prenat Diagn. 2002 Nov;22(11):976-8. doi: 10.1002/pd.450.
We report a fetus with fetal bradycardia at 13 weeks of gestation secondary to atrial extrasystoles. The fetus subsequently developed paroxysmal supraventricular tachycardia and hydrops fetalis. The cardiac arrhythmia recovered spontaneously without any medical intervention. This case illustrates that atrial ectopic beats can present in the first trimester with fetal bradycardia. Rapidly evolving hydrops fetalis secondary to supraventricular tachycardia can develop, warranting close monitoring with weekly heart rate assessment. Fetal bradycardia secondary to atrial extrasystole should be differentiated from first trimester sinus bradycardia and those associated with major structural cardiac abnormality, which have a high fetal loss rate.
我们报告了一例妊娠13周时因房性期前收缩继发胎儿心动过缓的胎儿。该胎儿随后发展为阵发性室上性心动过速和胎儿水肿。心律失常未经任何医学干预而自发恢复。本病例表明，房性异位搏动可在孕早期出现并伴有胎儿心动过缓。继发于室上性心动过速的快速进展性胎儿水肿可能会发生，因此需要每周进行心率评估以密切监测。应将房性期前收缩继发的胎儿心动过缓与孕早期窦性心动过缓以及与主要心脏结构异常相关的心动过缓相鉴别，后者胎儿丢失率较高。
