Key result
Maternal direct current cardioversion at 17 weeks of gestation was followed by sustained and progressive fetal sinus bradycardia, necessitating cesarean delivery at 37 weeks.
Why the study?
Does maternal cardioversion cause fetal bradycardia in pregnant women with atrial flutter?
Case Report (n=1)
No
Does maternal cardioversion cause fetal bradycardia in pregnant women with atrial flutter?
Although maternal cardioversion is generally considered safe during pregnancy, it may be associated with delayed, sustained fetal sinus bradycardia, highlighting the need for careful fetal monitoring.
Answers are grounded in this paper and cite their sources.
May signal delayed fetal bradycardia risk after maternal cardioversion; leaves open causality and need for routine monitoring in larger studies.
Direct current cardioversion is reported as a safe procedure during pregnancy. However, the impact of cardioversion on fetal haemodynamics remains unclear. A 28-year-old woman at 10 2/7 weeks of gestation developed shortness of breath while walking. Under the confirmation of atrial flutter by a 12-lead electro-cardiogram, synchronized shock was proceeded at 17 weeks of gestation and the maternal heart rhythm was converted to sinus rhythm. After 3 months, the baseline of fetal heart rate decreased to 110 beats per minute. Fetal bradycardia was aggravated at term, and caesarean section was performed. Following caesarean section, the infant made a full recovery. Although cardioversion during pregnancy is known to be safe, monitoring of fetal heart rate during maternal cardioversion is advisable considering the possibility of severe fetal bradycardia and loss of variability.
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Hwangbo et al. (2011) conducted a case report in Atrial flutter during pregnancy (n=1). Direct current cardioversion was evaluated on Fetal heart rate. Maternal direct current cardioversion at 17 weeks of gestation was followed by sustained and progressive fetal sinus bradycardia, necessitating cesarean delivery at 37 weeks.
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