Abinader E G, Klein A, Eibschitz I, Zilberman A, Pezeshk B, Sharf M
Am J Obstet Gynecol. 1976 Sep 15;126(2):266-70. doi: 10.1016/0002-9378(76)90288-x.
From 11 cases of fetal bradycardia diagnosed by monitoring of 130 fetal electrocardiograms (ECG's) in high-risk pregnancies we have presented our experience in three selected cases of fetal bradyarrthythmia. Case 1 revealed on ECG blocked atrial premature beats simulating an extreme sinus bradycardia sequentially followed by conducted atrial premature beats. In case 2 we diagnosed ventricular premature beats in the form of persistent bigeminy which was controlled by intravenous propranolol. The last case illustrated the phenomenon of aberrant ventricular conduction known to occur in adult cardiology. The electrophysiologic basis of the variable arrhythmias was discussed. Detailed analysis of repeated direct fetal ECG's provided us with the diagnosis and understanding of the electrophysiologic mechanisms underlying the rhythm disturbances. This consequently determined the pharmacologic therapy and the obstetric approach relevant to each case. We have shown that by direct fetal electrocardiography it is possible to analyze accurately the rhythm disturbances. Persistent fetal bradycardia does not always signify fetal distress. We hope that this will lead to closer teamwork between the obstetrician and the cardiologist which will give an impetus to the future development of "fetal cardiology," thereby enhancing our understanding of the electrophysiology of the fetal heart.
在对130例高危妊娠胎儿进行心电图监测所诊断出的11例胎儿心动过缓病例中，我们展示了3例胎儿心律失常的经验。病例1的心电图显示房性早搏阻滞，类似极度窦性心动过缓，随后依次出现下传的房性早搏。病例2中，我们诊断为持续性二联律形式的室性早搏，通过静脉注射普萘洛尔得到控制。最后一例说明了成人心脏病学中已知的心室差异性传导现象。讨论了各种心律失常的电生理基础。对重复的直接胎儿心电图进行详细分析，使我们能够诊断并理解心律失常背后的电生理机制。这进而确定了与每个病例相关的药物治疗和产科处理方法。我们已经表明，通过直接胎儿心电图可以准确分析心律失常。持续性胎儿心动过缓并不总是意味着胎儿窘迫。我们希望这将促使产科医生和心脏病专家更紧密地合作，推动“胎儿心脏病学”的未来发展，从而增进我们对胎儿心脏电生理学的理解。
