Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan-Feb;24(1):20-24.
doi: 10.1016/j.ipej.2023.10.003. Epub 2023 Oct 13.

Prenatal diagnosis of fetal bradyarrhythmia and postnatal outcome

Keerthana Kothandaraman  1 , Ponmozhi Ganesan  1 , Vikram Nadig Ns  1 , K Manikandan  2
Affiliations

Prenatal diagnosis of fetal bradyarrhythmia and postnatal outcome

Keerthana Kothandaraman et al. Indian Pacing Electrophysiol J. 2024 Jan-Feb.

Abstract

Introduction: Prenatal diagnosis of Fetal bradyarrhythmia leads to parental and care provider anxiety as data on outcome is scarce. We aimed to correlate the prenatal presentation of fetal bradyarrhythmia with postnatal outcome.

Methods: Retrospective analysis of case records from 2017 to 2021. All fetuses with sustained bradyarrhythmia beyond 11 weeks were included in the study.

Results: Twenty fetuses were identified: mean gestational age at diagnosis was 23 weeks 2 days. The type of bradyarrhythmia was as follows: Complete atrioventricular block 10 (50 %), Sinus Bradycardia 7 (35 %), second degree atrioventricular block 2 (10 %), and Unclassified 1 (5 %). In 10 fetuses, cardiac and extracardiac anatomy were normal; 8 fetuses (40 %) had cardiac anomalies,1 fetus had intraventricular hemorrhage and 1 had nuchal cystic hygroma. Among the fetuses with associated anomalies, there were 5 terminations of pregnancy (TOP), 1 intrauterine fetal demise (IUD), 3 neonatal demise (NND) and 1 livebirth. Among fetuses with normal anatomy, there were 2 TOP and 8 livebirths; five of the 10 mothers (50 %) tested positive for Anti Ro/La antibodies. All the 6 liveborn fetuses with complete atrioventricular block are on conservative management: 2 on metaproterenol and 4 on clinical follow up. Nine out of the 10 cases that had a postnatal paediatric cardiology assessment had a correct prenatal diagnosis.

Conclusion: Correct prenatal identification of fetal bradyarrhythmia is feasible in about 90 % of cases. The risk of postnatal pacemaker requirement appears to be low irrespective of maternal Anti Ro/La status.

Keywords: Antenatal steroids; Atrioventricular block; Congenital heart disease; Fetal bradyarrhythmia; Pacemaker.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
M-mode examination of atrioventricular mechanical events showing complete dissociation between atrial contractions (long arrow) and ventricular contractions (arrowhead) indicating complete AV block in panel A; atrial rate twice the ventricular rate indicating 2:1 AV block in panel B; atrial rate and ventricular rate at 1:1 conduction indicating sinus bradycardia in panel C
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Hornberger L.K., Sahn D.J. Rhythm abnormalities of the fetus. Heart. 2007;93(10):1294–1300. doi: 10.1136/hrt.2005.069369. - DOI - PMC - PubMed
    1. Caruso E., Farruggio S., Agati S., Mambro C. Fetal bradyarrhythmias: etiopathogenesis, diagnosis and treatment: between literature review and experience of a tertiary center. Congenit Heart Dis. 2021;16 doi: 10.32604/CHD.2021.015470. - DOI
    1. ACOG Practice Bulletin No. 106 Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009;114(1):192–202. doi: 10.1097/AOG.0b013e3181aef106. - DOI - PubMed
    1. Eliasson H., Wahren-Herlenius M., Sonesson S.E. Mechanisms in fetal bradyarrhythmia: 65 cases in a single center analyzed by Doppler flow echocardiographic techniques. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2011;37(2):172–178. doi: 10.1002/uog.8866. - DOI - PubMed
    1. Srinivasan S., Strasburger J. Overview of fetal arrhythmias. Curr Opin Pediatr. 2008;20(5):522–531. doi: 10.1097/MOP.0b013e32830f93ec. - DOI - PMC - PubMed