FETAL ARRHYTHMIA: EXPERIENCE OF ONE PERINATAL CENTER

Abstract

Aim of the study. To determine the influence of fetal arrhythmias on perinatal outcomes among women who gave birth in 2017–2021 at Hospital of Lithuanian University of Health Sciences Kauno klinikos. Methods. A retrospective descriptive study was performed in which records of birth and disease histories of 38 mothers and their newborns were analyzed. The objectives of the study were to determine the prevalence of fetal arrhythmias, to assess the need for fetal arrhythmia monitoring and treatment during pregnancy, to determine the effect of fetal arrhythmia on the fetus, to determine the influence of fetal arrhythmias on unfavorable perinatal outcomes. Results. The prevalence of fetal arrhythmias among women who gave birth in Kauno klinikos is 0.3 %. Premature heart contractions were the most common fetal arrhythmia 79 % (30 cases), less frequently tachycardia (7 cases) and one case of bradycardia. One patient received antiarrhythmic therapy during pregnancy. 4 patients underwent cesarean section due to suspected fetal distress, 3 of them had preterm birth (3 due to SVT and one due to II° atrioventricular block and multiple fetal malformations). A congenital heart malformation was found in 4 cases, and in one case the newborn did not survive due to a complex heart defect and cardiac decompensation. For most newborns, the arrhythmia resolved after birth. Conclusions. Premature contractions are most commonly detected fetal arrhythmia. In all patients with suspected tachyarrhythmia or bradyarrhythmia, fetal echocardiography should be performed to evaluate cardiac structures and functions due to congenital heart malformations and heart decompensation. Etiology and fetal condition are the main determinants of the management strategy for fetal tachyarrhythmias and bradyarrhythmias.