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Hwangbo, Bae, Heo, Kim, and Seong: Sustained fetal sinus bradycardia after maternal cardioversion
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(1): 53-56.

Published online: 31 January 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.1.53

Sustained fetal sinus bradycardia after maternal cardioversion

Ji Hye Hwangbo, MD, Jin Young Bae, MD, Eun Young Heo, MD, Mi Ju Kim, MD, Won Joon Seong, MD

Department of Obstetrics and Gynecology, Kyungpook National University School of Medicine, Daegu, Korea.

Corresponding author: Jin Young Bae, MD. Department of Obstetrics and Gynecology, Kyungpook National University Hospital, 50 Samdeok 2-ga, Jung-gu, Daegu 700-721, Korea. Tel: +82-53-420-5724, Fax: +82-53-423-7905, duchess7@naver.com

Received 19 November 2010       Revised 30 December 2010       Accepted 3 January 2011

Copyright © 2010 Korean Society of Obstetrics and Gynecology

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.

Keywords: Maternal cardioversion, Fetal bradycardia, Arrhythmia

Figures and Tables

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