Value of dual Doppler ultrasonography in the evaluation of fetal arrhythmias

Abstract

Objective To evaluate the value of fetal dual Doppler ultrasonography in the diagnosis of fetal arrhythmias. Methods 77 531 fetuses were examined by echocardiography.If fetal arrhythmias were found, information of pulsed wave Doppler signals in hepatic vein (HV) and descending aorta (DAo) using dual Doppler were collected simultaneously. Results On dual Doppler examination, 131 of the fetuses showed signals of cardiac dysrhythmias, including 60 fetuses with irregular fetal heart rhythm but having normal heart rate, 45 with tachyarrhythmias and 26 with bradyarrhythmias. Sixteen and 2 with tachy- or bradyarrhythmias fetuses complicated fetal malformation or severely maternal systemic diseases. Eighteen and 3 with tachy- or bradyarrhythmias fetuses revealed intrauterine death or intermediate pregnancy induction. The three main kinds of fetal arrhythmias had statistical differences in complicating with fetal malformation, maternal diseases, intrauterine fetal demise or intermediate pregnancy induction(all P<0.05). There was a significant difference in the accuracy of diagnosing rhythm abnormalities in the fetus between conventional ultrasonography and dual Doppler ultrasonography(k=0.562, P<0.05). Sixty cases of irregular fetal heart rhythm, 42 cases of fetal tachyarrhythmias, and 8 cases of fetal bradyarrhythmias were changed to normal rhythm at the third-pregnancy or prenatal period through appropriate treatment. All surviving fetuses were examined by echocardiography within 3 days, without any combination of congenital heart disease, and 1 months after the delivery, the ECG were shown as sinus rhythm. Conclusions Dual Doppler ultrasonography is a precise and rapid method of assessing various types of fetal arrhythmias. Different types of fetal arrhythmias have different fetal prognosis. Key words: Echocardiography, Doppler; Fetal heart; Arrhythmias; Dual Doppler