Fetal arrhythmias: Ten years' experience and review of the literature/Fetal aritmiler: On yillik deneyim ve literatur taramasi

Objective: Fetal arrhythmias complicate 1-2% of all pregnancies. Ultrasound evaluation and Doppler technology are indispensable in both diagnosis and management. Digoxin, sotalol, flecainide and amiodarone are widely accepted antiarrhythmic agents that are frequently. We reviewed the maternal and fetal outcomes in cases with fetal arrhythmia in a tertiary care center in the last decade. Materials and Methods: Fetal arrhythmias were classified under three main groups: Irregular rhythms, tachyarrhythmia and bradyarrhythmia. Detailed anatomical evaluation and fetal echocardiography were performed in all cases to determine whether a structural cardiac and extracardiac anomaly accompanied fetal arrhythmia and the type of fetal arrhythmia. Digoxin was started primarily as first-line therapy in patients with persistent fetal tachyarrhythmia. In cases, not responding to digoxin, other antiarrhythmic agents (sotalol, flecainide) were combined with treatment without discontinuing digoxin. Results: Fetal arrhythmia was detected in 36 cases during the study period. 50% (n=18/36) of the cases had supraventricular tachycardia, whereas 28% (n=10/36) of them were fetal bradyarrhythmia and 22% (n=8/36) of them were with various irregular rhythms. Transplacental therapy was initiated in 13 patients with persistent supraventricular tachycardia and atrial flutter regardless of the presence of hydrops. The success rate in transplacental therapy was 77% (n=10/13). Conclusion: Successful transplacental therapy was achieved in approximately 80% of cases and delivery could be postponed to advanced gestational weeks, confirming the crucial role of this treatment for the management of tachyarrhythmia. Keywords: Fetal arrhythmia, fetal tachyarrhythmia, fetal bradyarrhythmia, transplacental therapy, hydrops fetalis Amac: Fetal aritmiler tum gebeliklerin %1-2'sini komplike etmektedir. Ultrason degerlendirmesi ve Doppler teknolojisi hem tani hem de yonetimde vazgecilmezdir. Digoksin, sotalol, flekainid ve amiadaron transplasental tedavide siklikla kullanilan, yaygin olarak kabul gormus ajanlardir. Son 10 yilda, ucuncu basamak bir saglik merkezinde fetal aritmili olgularda maternal ve fetal sonuclari gozden gecirmeyi amacladik. Gerec ve Yontemler: Fetal aritmiler uc ana gruba ayrildi: Duzensiz ritimler, tasiaritmiler ve bradiaritmiler. Tum olgularda fetal aritmiye kardiyak yapisal ve ekstrakardiyak anomalinin eslik edip etmedigini ve fetal aritminin tipini belirlemek icin detayli anatomi