"Antepartum noninvasive evaluation of persistant fetal cardiac arrhythmias" (author's transl)

Abstract

Fetal cardiac arrhythmias are increasingly more frequently discovered by cardiotocographic monitoring beginning at the 30th week of gestation. The computation of systolic time intervals represents a noninvasive technique to evaluate the cardiovascular performance of these fetuses. The pre-ejection period, ventricular ejection time and duration of systole of 41 healthy fetuses, two fetuses with supraventricular tachycardia and one with complete atrio-ventricular block were computed on the basis of abdominal fetal electrocardiogram and phonocardiogram. One fetus with supraventricular tachycardia had a pathologic prolonged pre-ejection period and duration of systole. This fetus became acidotic during delivery and died from persistent cardiac arrhythmia and congestive heart failure after 2 years. Further investigations should be done in order to prove, if a prolonged pre-ejection period and duration of systole have a significant value. According to the present experiences of the author a vaginal delivery can be recommended, if normal systolic time intervals exist in the arrhythmic fetus.