Diagnosis and Management of Fetal Bradyarrhythmias

Authors: JAEGGI, EDGAR T.; FRIEDBERG, MARK K.

Source: Pacing and Clinical Electrophysiology, Volume 31, Supplement 1, February 2008 , pp. S50-S53(4)

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Abstract:

Complete atrioventricular block (CAVB) is the most common cause of persistent fetal bradycardia. In the presence of a structurally normal heart, it develops primarily in anti-Ro and anti-La positive antibody pregnancies after 20 weeks of gestation. There is a significant risk of perinatal demise, particularly in association with fetal hydrops, poor ventricular function, and heart rates < 55 beats/min. Transplacental treatment strategies are aimed at preventing or modulating these risk factors. Maternal administration of dexamethasone to mitigate or prevent concomitant myocardial inflammation, in combination with β-stimulation for persistent fetal bradycardia < 55 beats/min to increase fetal cardiac output, has resulted in significantly improved fetal and neonatal outcomes without reversing CAVB.

(PACE 2008; 31:S50-S53)

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1540-8159.2008.00957.x

Affiliations: 1: Fetal Cardiac Program, Division of Cardiology, The Hospital for Sick Children, Toronto, Canada

Publication date: 2008-02-01

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