Abstract:

Background/Aims Fetal arrhythmias are one of the challenging diseases in pregnancies and have an important impress on fetal health. This study aims to evaluate diagnosis methods, treatment plans, and prognosis for these disorders. Methods Fetuses diagnosed with fetal arrhythmia between January 2018 and January 2021 were retrospectively screened from hospital records and 28 fetuses were identified. Results Fetal arrhythmia was detected in 28 fetuses out of 1254 pregnant women (2.2%). Irregular rhythm was observed in 21/28(75%) of the fetuses, supraventricular tachycardia in 4/28 fetuses (14.2%), and fetal atrioventricular(AV) block in 3/28 fetuses (10.7%). All fetuses with tachycardia were hospitalized and digoxin was started at the appropriate dose. In 1/4 of fetuses with atrial tachycardia/fibriloflutter; sotalol was added and combined treatment was started. In the other fetus with persistent tachycardia, sotalol was also added to achieve the rate control. Cardioversion was applied to the newborn who had atrial fibriloflutter at birth. In this newborn, a propafenone propranolol amiodarone triple combination was started and tachycardia was controlled. There was neither intrauterine death nor mortality in the postnatal period in patients with tachycardia. WPW syndrome was detected in one patient after birth. Prolonged medical treatment for at least two years is planned in patients with WPW syndrome and atrial fibriloflutter.2 fetuses with complete AV block and complex congenital heart diseases had died in the intrauterine period. The other fetus with AV block had neonatal lupus and this patient also died due to heart failure in the postnatal period. Conclusions Fetal heart rhythm disorders can be detected prenatally with fetal echocardiography Doppler approach. Anti-arrhythmic drugs could be considered depending on the fetuses’ well-being. The mother's diet, and lupus antibodies should be considered in elucidating the etiology.

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