Wacker-Gussmann Annette, Strasburger Janette F, Cuneo Bettina F, Wakai Ronald T
Department of Neonatology, University Children's Hospital, Tuebingen, Germany.
Division of Cardiology, Department of Pediatrics, Children's Hospital of Wisconsin-Milwaukee and Fox Valley, Milwaukee, Wisconsin.
Am J Perinatol. 2014 Aug;31(7):617-28. doi: 10.1055/s-0034-1372430. Epub 2014 May 23.
Detection and careful stratification of fetal heart rate (FHR) is extremely important in all pregnancies. The most lethal cardiac rhythm disturbances occur during apparently normal pregnancies where FHR and rhythm are regular and within normal or low-normal ranges. These hidden depolarization and repolarization abnormalities, associated with genetic ion channelopathies cannot be detected by echocardiography, and may be responsible for up to 10% of unexplained fetal demise, prompting a need for newer and better fetal diagnostic techniques. Other manifest fetal arrhythmias such as premature beats, tachycardia, and bradycardia are commonly recognized.
Heart rhythm diagnosis in obstetrical practice is usually made by M-mode and pulsed Doppler fetal echocardiography, but not all fetal cardiac time intervals are captured by echocardiographic methods.
This article reviews different types of fetal arrhythmias, their presentation and treatment strategies, and gives an overview of the present and future diagnostic techniques.
在所有妊娠中，检测并仔细分层胎儿心率（FHR）极为重要。最致命的心律失常发生在表面正常的妊娠期间，此时FHR和心律规则且处于正常或略低于正常范围。这些与遗传性离子通道病相关的隐藏去极化和复极化异常无法通过超声心动图检测到，可能导致高达10%的不明原因胎儿死亡，这促使人们需要更新、更好的胎儿诊断技术。其他明显的胎儿心律失常，如早搏、心动过速和心动过缓则较为常见。
产科实践中的心律诊断通常通过M型和脉冲多普勒胎儿超声心动图进行，但并非所有胎儿心脏时间间隔都能通过超声心动图方法获取。
本文回顾了不同类型的胎儿心律失常、其表现和治疗策略，并概述了当前和未来的诊断技术。
