32例妊娠晚期胎儿心律不齐临床分析

A clinical analysis of 32 cases of fetal arrhythmia in late pregnancy

目的 分析妊娠晚期胎儿心律不齐的原因、产科处理及预后.方法 回顾性分析咸阳市第一人民医院妇产科2004年12月～2009年12月经产前检查发现妊娠晚期胎儿心律不齐收住院的32例临床资料,分别记录母亲疾病史、胎儿心律不齐的种类、产科处理及预后.结果 ①32例妊娠晚期胎儿心律不齐中有14例（43.75%）的母亲孕前及孕期均无疾病,其余有心脏病史、孕期病毒感染史和服抗心律失常药物史;②32例妊娠晚期胎儿心律不齐的种类以房性、交界性及室性早搏为主,占40.63%,其次为性质不定性心律不齐;③新生儿中有3例房间隔缺损合并持续室性早搏,其余均恢复正常心律,无新生儿心功能衰竭及死亡病例.结论 大部分胎儿心律失常与孕期心脏发育不完善有关,可在出生后几天内恢复正常心律（率）,不需特殊处理.胎儿严重心律失常需积极治疗,合并房间隔缺损者需在婴儿期予以手术矫正.

Objective To analyze causes,obstetric management and pregnancy outcomes of fetal arrhythmias. Methods The clinical data of 32 pregnant women with fetal arrhythmia in late pregnancy admitted to The First Xianyang Municipal People＇ s Hospital in a 5-year period from December, 2004 to December, 2009 were analyzed retrospectively. The medical history of the mother, type of fetal arrhythmia, obstetric management and pregnancy outcomes women were recorded. Results （~） Among 14 cases of fetal arrhythmia in late pregnancy, 14 mothers（43.75% ） had no diseases before and during pregnancy, the others had histories of heart diseases, viral infection and taking anti- arrhythmic medicines during pregnancy; （~）The main types of fetal arrhythmia were atrial, junctional or vertricular premature beats （accounting for 40. 63%） and the others were undetermined fetal arrhythmia; （~）Among all neonates, 3 had persistent premature vertricular beats associated with atrial septal defect. No neonates died and no cardiac failure occurred. Conclusion Most of fetal arrhythmia are related to immature development of fetal heart during pregnancy and can recover to normal arrythmia or heart rate within several days after birth no needing special managements, but severe fetal arrhythmia should be treated actively. Fetal arrhythmia associated with atrial septal defect can be treated surgically in infancy.