Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Section 1 General principles
- Section 2 Fetal disease
- Chapter 6 Red cell alloimmunization
- Chapter 7 Fetal and neonatal alloimmune thrombocytopenia
- Chapter 8.1 Fetal dysrhythmias
- Chapter 8.2 Fetal dysrhythmias
- Chapter 9.1 Structural heart disease
- Chapter 9.2 Structural heart disease
- Chapter 9.3 Structural heart disease
- Chapter 10.1 Manipulation of amniotic fluid volume
- Chapter 10.2 Manipulation of amniotic fluid volume
- Chapter 11.1 Twin-to-twin transfusion syndrome
- Chapter 11.2 Twin-to-twin transfusion syndrome
- Chapter 11.3 Twin-to-twin transfusion syndrome
- Chapter 11.4 Twin-to-twin transfusion syndrome
- Chapter 11.5 Twin-to-twin transfusion syndrome
- Chapter 12.1 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 12.2 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 13.1 Fetal infections
- Chapter 13.2 Fetal infections
- Chapter 14.1 Fetal urinary tract obstruction
- Chapter 14.2 Fetal urinary tract obstruction
- Chapter 14.3 Fetal urinary tract obstruction
- Chapter 14.4 Fetal urinary tract obstruction
- 15.1 Fetal lung growth, development, and lung fluid
- Chapter 15.2 Fetal lung growth, development, and lung fluid
- Chapter 16.1 Neural tube defects
- Chapter 16.2 Neural tube defects
- Chapter 17.1 Fetal tumors
- Chapter 17.2 Fetal tumors
- Chapter 18.1 Intrauterine growth restriction
- Chapter 18.2 Intrauterine growth restriction
- Chapter 19.1 Congenital diaphragmatic hernia
- Chapter 19.2 Congenital diaphragmatic hernia
- Chapter 20.1 Fetal stem cell transplantation
- Chapter 20.2 Fetal stem cell transplantation
- Chapter 20.3 Fetal stem cell transplantation
- Chapter 21 Gene therapy
- Chapter 22 The future
- Glossary
- Index
- References
Chapter 8.2 - Fetal dysrhythmias
Clinical management
from Section 2 - Fetal disease
Published online by Cambridge University Press: 05 February 2013
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Section 1 General principles
- Section 2 Fetal disease
- Chapter 6 Red cell alloimmunization
- Chapter 7 Fetal and neonatal alloimmune thrombocytopenia
- Chapter 8.1 Fetal dysrhythmias
- Chapter 8.2 Fetal dysrhythmias
- Chapter 9.1 Structural heart disease
- Chapter 9.2 Structural heart disease
- Chapter 9.3 Structural heart disease
- Chapter 10.1 Manipulation of amniotic fluid volume
- Chapter 10.2 Manipulation of amniotic fluid volume
- Chapter 11.1 Twin-to-twin transfusion syndrome
- Chapter 11.2 Twin-to-twin transfusion syndrome
- Chapter 11.3 Twin-to-twin transfusion syndrome
- Chapter 11.4 Twin-to-twin transfusion syndrome
- Chapter 11.5 Twin-to-twin transfusion syndrome
- Chapter 12.1 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 12.2 Twin reversed arterial perfusion (TRAP) sequence
- Chapter 13.1 Fetal infections
- Chapter 13.2 Fetal infections
- Chapter 14.1 Fetal urinary tract obstruction
- Chapter 14.2 Fetal urinary tract obstruction
- Chapter 14.3 Fetal urinary tract obstruction
- Chapter 14.4 Fetal urinary tract obstruction
- 15.1 Fetal lung growth, development, and lung fluid
- Chapter 15.2 Fetal lung growth, development, and lung fluid
- Chapter 16.1 Neural tube defects
- Chapter 16.2 Neural tube defects
- Chapter 17.1 Fetal tumors
- Chapter 17.2 Fetal tumors
- Chapter 18.1 Intrauterine growth restriction
- Chapter 18.2 Intrauterine growth restriction
- Chapter 19.1 Congenital diaphragmatic hernia
- Chapter 19.2 Congenital diaphragmatic hernia
- Chapter 20.1 Fetal stem cell transplantation
- Chapter 20.2 Fetal stem cell transplantation
- Chapter 20.3 Fetal stem cell transplantation
- Chapter 21 Gene therapy
- Chapter 22 The future
- Glossary
- Index
- References
Summary
Introduction
Assessment of fetal heart rate (FHR) and its regularity is part of clinical management of all pregnancies during routine antenatal visits. By simple auscultation of the fetal heart, doctors and midwives can promptly detect abnormal patterns (“fetal dysrhythmia”) and therefore, bradycardias, tachycardias, and irregular rhythms are easily recognized.
However, whilst identifying a dysrhythmia should prompt further assessment in all cases, having a basic understanding of the various diagnostic possibilities leading to rhythm disturbances is important. Establishing a local protocol to guide referral may be the first step to manage the rhythm abnormality in a timely and safe manner. This way, most families can be appropriately reassured and the fewer cases for whom fetal monitoring and therapy may be indicated can be seen by a specialist without delay.
At specialist level, accurate assessment of the rhythm abnormality, its hemodynamic consequences and assessment of fetal well-being will determine the need for fetal intervention. In this chapter, we aim to provide a logical approach to diagnosis (primarily based on ultrasound) and discuss current management of fetal dysrhythmias.
Keywords
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- Information
- Fetal TherapyScientific Basis and Critical Appraisal of Clinical Benefits, pp. 87 - 99Publisher: Cambridge University PressPrint publication year: 2012