Importance of Analysis of Arrhythmia Mechanism in Predicting Outcomes in Fetal Bradycardia: A Single-Centre Retrospective Study from a Dedicated Fetal Cardiology Unit in South India

This study aimed to correlate the  arrhythmia mechanism to pregnancy and early postnatal outcomes in fetal bradycardia. This was retrospective study (May 2013–November 2019). Fetuses with sustained bradycardia (heart rate ≤ 100 per minute) were included. Based on arrhythmia mechanism, patients were categorized into 4 group s:Group 1: blocked atrial ectopics, Group 2: second-degree atrioventricular block (AVB), Group 3: complete AVB and group 4: sinus bradycardia. Clinical presentation, need for transplacental therapy, pregnancy and early postnatal outcomes were analysed. A total of 36 patients were included. Mean ge stational age was 26.2 ± 5.5 weeks. The most common arrhythmia mechanism was Group 3 (N = 24; 66.7%) followed by Group 2 (N = 5; 13.8%); groups 1 and 4 had 4 and 3 patients respectively. Maternal auto-antibodies were reported in 21 patients (58.3%); 19 were in Group 3. Transplacental t herapy was needed in 15 (41.7%) cases; 14 were in Group 3. Live-birth was reported in 23 cases (63.9%), other outcomes included pregnancy termination (n = 7), intra-uterine death (n = 4) and lost to follow-up (n = 2). Live-births were most common in Groups 1 (100%) and 2 (80%), followed by Group 3 (54.2%). Postnatal mortality occurred in one patient (Group 2). Three patients (60%) in Group 2 had Long QT syndrome in postnatal evaluation. Eight patients (6 in group 3) needed pacemaker implantation after birth. Fetal bradycardia was associated with...
Source: Journal of Fetal Medicine - Category: Perinatology & Neonatology Source Type: research