Korean J Obstet Gynecol.  2011 Jan;54(1):53-56. 10.5468/KJOG.2011.54.1.53.

Sustained fetal sinus bradycardia after maternal cardioversion

• Hwangbo JH
• Bae JY
• Heo EY
• Kim MJ
• Seong WJ

• KMID: 2274023
• DOI: http://doi.org/10.5468/KJOG.2011.54.1.53

Abstract

Direct current cardioversion is reported as a safe procedure during pregnancy. However, the impact of cardioversion on fetal haemodynamics remains unclear. A 28-year-old woman at 10 2/7 weeks of gestation developed shortness of breath while walking. Under the confirmation of atrial flutter by a 12-lead electro-cardiogram, synchronized shock was proceeded at 17 weeks of gestation and the maternal heart rhythm was converted to sinus rhythm. After 3 months, the baseline of fetal heart rate decreased to 110 beats per minute. Fetal bradycardia was aggravated at term, and caesarean section was performed. Following caesarean section, the infant made a full recovery. Although cardioversion during pregnancy is known to be safe, monitoring of fetal heart rate during maternal cardioversion is advisable considering the possibility of severe fetal bradycardia and loss of variability.

Keyword

Maternal cardioversion; Fetal bradycardia; Arrhythmia

MeSH Terms

Adult
Arrhythmias, Cardiac
Atrial Flutter
Bradycardia
Cesarean Section
Dyspnea
Electric Countershock
Female
Heart
Heart Rate, Fetal
Humans
Infant
Morphinans
Pregnancy
Shock
Walking
Morphinans

Figure

• 

  Fig. 1 At 29 3/7 weeks of gestation, pulse doppler exam revealed decreased fetal heart rate to 114 beats/min.

• 

  Fig. 2 At 37 1/7 weeks of gestation, fetal monitoring showed aggravated fetal bradycardia and decreased variability.

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  Fig. 3 Nineteen days after birth, neonatal echocardiography showed slightly quickening blood flow of ascending aorta and focal stenotic lesion of aorta was not revealed.

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