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[胎儿心律失常问题——病例报告]

[Problem of fetal arrhythmias--a case report].

作者信息

Voigt H J, Singer H

出版信息

Z Geburtshilfe Perinatol. 1985 Jan-Feb;189(1):17-21.

PMID:3993138
Abstract

A fetal congenital complete AV-block was detected in the 30th week of gestation. After close sonographic and cardiotocographic follow-up examinations premature labor occurred in the 37th week of gestation. The interpretation of the fetal heart rate pattern was difficult. The bradycardia was accompanied by late decelerations (dip II), only different from familiar hypoxia-patterns by the bradycardia. Caesarean section therefore was immediately done. A partial abruptio placentae was found as causing hypoxia. The child developed well after insertion of a temporary transvenous pacemaker. The AV-block is still persisting. At the age of three months the child fell ill of an acute cutaneous lupus erythematosus. The symptoms disappeared after unspecific treatment. Antinuclear antibodies pathognomonic for lupus erythematosus were traceable in the symptomless mother. There are other observations of motherly autoantibodies passing the placental barrier impairing the fetal heart conduction.

摘要

妊娠30周时检测到胎儿先天性完全性房室传导阻滞。在密切的超声和胎心监护随访检查后,妊娠37周时出现早产。胎儿心率模式的解读很困难。心动过缓伴有晚期减速(II型下降),只是因心动过缓与常见的缺氧模式不同。因此立即进行了剖宫产。发现部分胎盘早剥是导致缺氧的原因。插入临时经静脉起搏器后,孩子发育良好。房室传导阻滞仍然存在。三个月大时,孩子患上了急性皮肤型红斑狼疮。经非特异性治疗后症状消失。在无症状的母亲体内可检测到对红斑狼疮具有诊断意义的抗核抗体。还有其他关于母体自身抗体穿过胎盘屏障损害胎儿心脏传导的观察报告。

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