Calvin S E, Gaziano E P, Bendel R P, Knox G E, Brandt D G
Perinatal Center, Abbott Northwestern Hospital.
Minn Med. 1992 Dec;75(12):29-31.
During a four-year period, 3,882 fetal diagnostic ultrasounds were performed and 162 patients (4% of all patients scanned) were referred to our perinatal center for evaluation of fetal cardiac arrhythmia. Fetal echocardiography subsequently revealed an arrhythmia in 80 (49%) of these patients. The rhythm disturbances noted were premature atrial or ventricular contractions (n = 65, 81%), tachyarrhythmia (n = 8, 10%), and bradyarrhythmia (n = 7, 9%). Three of the bradycardic fetuses evaluated had complete heart block associated with anatomic abnormalities. In seven tachycardic fetuses, the finding of fetal compromise was followed by intervention. The majority of fetuses with cardiac rhythm disturbance will have premature atrial or ventricular contractions and will have normal echocardiographic evaluation and neonatal outcome. Sustained tachyarrhythmias and bradyarrhythmias are more likely to be associated with fetal morbidity. Based upon the findings of this study and others, we propose a scheme for follow-up of the fetus referred with an irregular cardiac rhythm.
在四年期间，共进行了3882次胎儿诊断性超声检查，其中162例患者（占所有接受扫描患者的4%）被转诊至我们的围产期中心，以评估胎儿心律失常。随后，胎儿超声心动图显示其中80例患者（49%）存在心律失常。记录到的节律紊乱包括房性或室性早搏（n = 65，81%）、快速心律失常（n = 8，10%）和缓慢性心律失常（n = 7，9%）。接受评估的3例心动过缓胎儿伴有与解剖异常相关的完全性心脏传导阻滞。在7例快速心律失常胎儿中，发现胎儿窘迫后进行了干预。大多数有心脏节律紊乱的胎儿会出现房性或室性早搏，超声心动图评估和新生儿结局正常。持续性快速心律失常和缓慢性心律失常更有可能与胎儿发病相关。基于本研究及其他研究的结果，我们提出了一个针对心律不规则转诊胎儿的随访方案。
