Key result
Among 182 fetuses with dysrhythmia, benign atrial extrasystoles were most common, SVT responded well to therapy, and bradyarrhythmia with congenital heart disease had poor survival (20%).
Observational (n=318)
No
Benign atrial extrasystoles are the most common fetal dysrhythmia, while SVT has a good prognosis with transplacental therapy and bradyarrhythmia associated with congenital heart disease has a poor prognosis.
Supports subtype-specific fetal dysrhythmia counseling; leaves open prospective trials to validate therapy responses.
OBJECTIVE: To review the prenatal diagnosis, management and outcome of fetal dysrhythmia. SUBJECTS AND METHODS: Prenatal diagnosis, management and outcomes of fetuses with dysrhythmia were reviewed retrospectively (01/01/1997 to 31/12/2004). RESULTS: Over an 8-year period, 318 pregnant mothers were referred for assessment of suspected fetal dysrhythmias. Median gestation was 30 weeks (range 19-41). Fetal dysrhythmia was identified in 182 (57%) and classified as: (i) 126 atrial extrasystoles; (ii) 26 tachyarrhythmia, and (iii) 30 bradyarrhythmia. Of the fetuses with tachyarrhythmia, 23 had supraventricular tachycardia (SVT), 2 atrial flutter and 1 sinus tachycardia. One death associated with severe hydrops occurred in the tachyarrhythmia group. 19 cases of SVT were successfully treated in utero. Both cases of atrial flutter required direct current cardioversion in the neonatal period. In the bradyarrhythmia group, there were 15 isolated cases and 10 cases associated with congenital heart disease, with 73 and 20% survival, respectively. CONCLUSIONS: Benign atrial extrasystoles are the commonest cause for referral and assessment of fetal dysrhythmia. The overall prognosis for SVT is good with the majority responding to transplacental therapy. In cases with congenital atrioventricular block, the outcome was less favourable, especially when the atrioventricular block was associated with congenital heart disease.
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Rasiah et al. (2011) conducted an observational in Fetal dysrhythmia (n=318). Fetal dysrhythmia was evaluated on Diagnosis, management and outcome of fetal dysrhythmia. Among 182 fetuses with dysrhythmia, benign atrial extrasystoles were most common, SVT responded well to therapy, and bradyarrhythmia with congenital heart disease had poor survival (20%).
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