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Fetal dysrhythmias

Carvalho, J (2019) Fetal dysrhythmias. BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY. ISSN 1521-6934 https://doi.org/10.1016/j.bpobgyn.2019.01.002
SGUL Authors: Carvalho, Julene

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Abstract

Fetal dysrhythmias are common, usually manifesting as irregular rhythms. Whilst most irregularities are benign and caused by isolated atrial ectopics, in a few cases, rhythm irregularity may indicate partial atrioventricular block, which has different aetiological and prognostic implications. We provide a flowchart for initial management of irregular rhythm, to help select cases requiring urgent specialist referral. Tachycardias and bradycardias are less frequent, can lead to haemodynamic compromise and may require in-utero therapy. Pharmacological treatment of tachycardia depends on type (supraventricular tachycardia or atrial flutter) and presence of hydrops, with digoxin, flecainide and sotalol being commonly used. An ongoing randomized trial may best inform about their efficacy. Bradycardia due to blocked bigeminy normally resolves spontaneously, but if due to established complete heart block there is no effective treatment. Ongoing research suggests hydroxychloroquine may reduce the risk of auto-immune atrioventricular block. Sinus bradycardia (rate < 3rd centile) may be a prenatal marker for long QT syndrome.

Item Type: Article
Additional Information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: 1114 Paediatrics And Reproductive Medicine, Obstetrics & Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
ISSN: 1521-6934
Dates:
DateEvent
9 January 2019Published Online
7 January 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
URI: http://openaccess.sgul.ac.uk/id/eprint/110539
Publisher's version: https://doi.org/10.1016/j.bpobgyn.2019.01.002

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