https://scholars.lib.ntu.edu.tw/handle/123456789/458831
標題: | Postnatal outcome of fetal bradycardia without significant cardiac abnormalities | 作者: | MING-TAI LIN FON-JOU HSIEH MING-KWANG SHYU CHIEN-NAN LEE JOU-KOU WANG MEI-HWAN WU |
公開日期: | 2004 | 卷: | 147 | 期: | 3 | 起(迄)頁: | 540-544 | 來源出版物: | American Heart Journal | 摘要: | Background A heart rate <100 beats/min may be present in 5% of fetuses with arrhythmia. In this study, we sought to define the feasibility of in utero diagnosis of the underlying mechanisms and the postnatal outcome. Methods The types of fetal bradycardia were defined by fetal echocardiogram. Fetuses with transient sinus bradycardia were excluded. Results From 1995-2000, a total of 18 fetuses were found to have bradycardia. Postnatal 12-lead electrocardiograms made at least 3 times during follow-up confirmed the cardiac rhythm in all except those terminated during pregnancy. Sick sinus bradycardia was noted in 4 patients (22 %), of whom 1 had a positive family history and 2 received permanent pacemakers at age 4 and 5 years. Frequent nonconducted atrial premature beats or nonconducted atrial bigeminy or trigeminy were noted in 5 (28%). All of them revealed normal sinus rhythm after birth. Atrioventricular (AV) block was noted in 6 (33%), of whom 3 were terminated due to severe heart failure, and another 2 fetuses received permanent pacemaker implantation soon after birth. Only 1 fetus whose mother showed normal levels of C3 and C4 recovered at late gestation. Most importantly, 3 patients (17%) developed intermittent bradycardia (AV block) and ventricular tachycardia during the fetal stage. They were found to have long QT syndrome. Two of them died during early infancy. One received in utero propranolol and postnatal propranolol and nicorandil with satisfactory control. Conclusion The mechanisms responsible for fetal bradycardia were diverse and could be characterized by fetal echocardiography. The prognosis was poor in those with long QT syndrome manifested as intermittent fetal bradycardia and tachycardia with AV dissociation. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/458831 | ISSN: | 0002-8703 | DOI: | 10.1016/j.ahj.2003.09.016 | SDG/關鍵字: | beta adrenergic receptor blocking agent; nicorandil; potassium channel stimulating agent; propranolol; article; artificial heart pacemaker; atrioventricular block; bradycardia; clinical article; controlled study; disease severity; extrasystole; family history; female; fetus disease; fetus electrocardiography; fetus heart rate; follow up; heart failure; heart rhythm; human; male; newborn; pregnancy; pregnancy termination; priority journal; sick sinus syndrome; sinus bradycardia; tachycardia; adult; bradycardia; cohort analysis; echocardiography; echography; fetus disease; heart block; long QT syndrome; mortality; prenatal diagnosis; prognosis; retrospective study; sick sinus syndrome; supraventricular premature beat; tachycardia; Adult; Atrial Premature Complexes; Bradycardia; Cohort Studies; Echocardiography; Female; Fetal Diseases; Heart Block; Humans; Long QT Syndrome; Pregnancy; Prenatal Diagnosis; Prognosis; Retrospective Studies; Sick Sinus Syndrome; Tachycardia |
顯示於: | 醫學系 |
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