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Chapter 8.2 - Fetal dysrhythmias

Clinical management

from Section 2 - Fetal disease

Published online by Cambridge University Press:  05 February 2013

By
Julene S. Carvalho
Edited by
Mark D. Kilby ,
Anthony Johnson  and
Dick Oepkes
Mark D. Kilby
Affiliation:
Department of Fetal Medicine, University of Birmingham
Anthony Johnson
Affiliation:
Baylor College of Medicine, Texas
Dick Oepkes
Affiliation:
Department of Obstetrics, Leiden University Medical Center
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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

fetal magnetocardiographyfetal electrocardiographyfetal dysrhythmiasfetal heart ratesupraventricular tachycardiatachycardiaselectrical cardiac impulsesatrial flutterbradycardias
Type
Chapter
Information
Fetal Therapy
Scientific Basis and Critical Appraisal of Clinical Benefits
 , pp. 87 - 99
Publisher: Cambridge University Press
Print publication year: 2012

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