ANTENATAL SONOGRAPHIC FEATURES AND PERINATAL OUTCOMES OF VARIOUS DISORDERS OF FETAL CARDIAC RHYTHM
Kharkiv Medical Academy of Postgraduate Education
M−mode echocardiography of 26 fetuses with assessment of atrioventricular conduction and simultaneous arteriovenous pulsed Doppler ultrasound was performed to determine ultrasound diagnostic criteria and improve prognosis of perinatal outcome in fetuses with different types of cardiac arrhythmias. Comparative analysis of perinatal outcomes was made, antenatal echo− and Doppler images were presented. Favorable perinatal outcome was observed in isolated atrial extrasystoles, atrial bigeminy or trigeminy, supraventricular tachycardia up to 205−215 beats/min with 1:1 antrioventricular conduction. Supraventricular tachycardia (200−220 beats/min) was accompanied by universal edema and required transplacental treatment. Sinus bradicardia, grade 2−3 atrioventricular block, supraventricular tachycardia with atrial flutter and 2:1 atrioventricular conduction, as well as ventricular tachycardia were associated with fetal distress or universal edema, perinatal loss, hemodynamic disorders. The majority of fetal arrhythmias are observed in the second half of pregnancy, which proves the necessity of the third ultrasound scanning. Upon detection of fetal arrhythmia with adverse or uneven perinatal prognosis delivery in a perinatal centre is preferable.
Key words: fetus, arrhythmia, antenatal ultrasound diagnosis, perinatal outcome.