Key result
Pregnancies complicated by fetal dysrhythmias had a 7.6% rate of spontaneous intrauterine fetal death and 5.7% neonatal death, with extracardiac anomalies, CHD, and Ro-antibodies predicting IUFD.
Why the study?
Fetal arrhythmias, especially in high-risk pregnancies, require special monitoring and treatment, prompting assessment of stillbirth and early and late neonatal mortality rates.
Cohort (n=157)
No
Fetal dysrhythmias carry a significant risk of intrauterine and neonatal death, with extracardiac anomalies, congenital heart disease, and Ro-antibodies serving as key predictors for adverse perinatal outcomes.
Supports intensified monitoring in fetal dysrhythmia pregnancies; leaves open whether targeting predictors improves outcomes.
Fetal dysrhythmias are common abnormalities, which can be categorized into three types: rhythm irregularities, tachyarrhythmias, and bradyarrhythmias. Fetal arrhythmias, especially in high-risk pregnancies, require special monitoring and treatment. The aim of this study was to assess the stillbirth and early and late neonatal mortality rates for pregnancies complicated by fetal dysrhythmias from one single tertiary referral center from 2000 to 2022. Of the 1018 fetuses with congenital heart disease, 157 (15.42%) were evaluated in this analysis. Seventy-four (46.7%) fetuses had bradyarrhythmias, 51 (32.5%) tachyarrhythmias, and 32 (20.4%) had rhythm irregularities. Additional structural heart defects were detected in 40 (25.3%) fetuses and extracardiac anomalies in 29 (18.4%) fetuses. Thirteen (8.2%) families opted for termination of the pregnancy. Eleven (7.6%), out of 144 continued pregnancies ended in spontaneous intrauterine fetal death (IUFD). Neonatal death was observed in nine cases (5.7%), whereas three (1.9%) died within the first 7 days of life. Although most intrauterine fetal deaths occurred in pregnancies with fetal bradyarrhythmia, neonatal death was observed more often in fetuses with tachyarrhythmia (8.5%). The presence of extracardiac anomalies, congenital heart disease (CHD), and Ro-antibodies are predictive factors for the occurrence of IUFD. Rhythm irregularities without any other risk factor do not present higher risks of adverse perinatal outcome.
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Springer et al. (2023) conducted a cohort in Fetal dysrhythmias (n=157). Fetal dysrhythmias was evaluated on Stillbirth and early and late neonatal mortality rates. Pregnancies complicated by fetal dysrhythmias had a 7.6% rate of spontaneous intrauterine fetal death and 5.7% neonatal death, with extracardiac anomalies, CHD, and Ro-antibodies predicting IUFD.
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