Lakhno Igor, Behar Joachim A, Oster Julien, Shulgin Vyacheslav, Ostras Oleksii, Andreotti Fernando
Department of Perinatology, Obstetrics and Gynecology Kharkiv Medical Academy of Postgraduate Education, 58 Amosova Street, Kharkiv, 61176 Ukraine.
Israel Institute of Technology - Technion, Haifa, Israel.
Matern Health Neonatol Perinatol. 2017 Aug 3;3:14. doi: 10.1186/s40748-017-0053-1. eCollection 2017.
Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex.
We present two retrospective case reports on which atrioventricular block diagnosis could have been supported by the non-invasive fetal electrocardiogram. The two cases comprised a 22-year-old pregnant woman with the gestational age of 31 weeks and a 25-year-old pregnant woman with the gestational age of 41 weeks. Both women were admitted to the Department of Maternal and Fetal Medicine at the Kyiv and Kharkiv municipal perinatal clinics. Patients were observed using standard fetal monitoring methods as well as the non-invasive fetal electrocardiogram. The non-invasive fetal electrocardiographic recordings were analyzed retrospectively, where it is possible to identify the presence of the atrioventricular block.
This study demonstrates, for the first time, the feasibility of the non-invasive fetal electrocardiogram as a supplementary method to diagnose of the fetal atrioventricular block. Combined with current fetal monitoring techniques, non-invasive fetal electrocardiography could support clinical decisions.
胎儿完全性房室传导阻滞大多与自身免疫性疾病相关，如果不进行类固醇治疗可能会不可逆。临床实践中用于诊断胎儿心律失常的传统方法有限，因为它们无法反映心肌中发生的主要电生理传导过程。无创胎儿心电图有潜力通过持续分析胎儿心率的逐搏变化以及PQRST波群的形态分析，更好地辅助胎儿心律失常的诊断。
我们呈现两例回顾性病例报告，无创胎儿心电图本可辅助诊断房室传导阻滞。两例分别为一名22岁、孕31周的孕妇和一名25岁、孕41周的孕妇。两名女性均入住基辅和哈尔科夫市围产期诊所的母胎医学科。使用标准胎儿监测方法以及无创胎儿心电图对患者进行观察。对无创胎儿心电图记录进行回顾性分析，从而有可能确定是否存在房室传导阻滞。
本研究首次证明无创胎儿心电图作为诊断胎儿房室传导阻滞的辅助方法的可行性。结合当前的胎儿监测技术，无创胎儿心电图可辅助临床决策。
