Decreased baseline variability on fetal heart rate pattern in a fetus with heterotaxy syndrome

作者：Yamada Ryutaro; Takei Kohta^*; Kaneshi Yosuke; Morikawa Mamoru; Cho Kazutoshi; Minakami Hisanori

来源：Journal of Obstetrics and Gynaecology Research, 2015, 41(12): 1988-1990.

DOI：10.1111/jog.12824

• cardiotocogram
• congenital cardiac malformation
• fetal arrhythmia
• fetal heart rate pattern
• isomerism

In a fetus with suspected heterotaxy syndrome, a decreased/absent baseline variability of fetal heart rate pattern developed at gestational week 36(+5) and continued for 5 days until birth at gestational week 37(+2), while repeat biophysical profile scorings with ultrasound were consistently unremarkable. This neonate weighing 2404 g with Apgar scores of 7 (1-min) and 8 (5-min) and umbilical arterial cord blood pH of 7.28 with base deficit of 3.9mmol/L, showed a heart rate of 120 b.p.m. for 3 h after birth, but subsequently developed sinus bradycardia (84 b.p.m.) unresponsive to crying. Isoproterenol initiated 9 h after birth was effective in the increase of heart rate to 120 b.p.m. in this neonate. Brain magnetic resonance imaging at 16 days of age was unremarkable. The decreased/absent baseline variability of fetal heart rate pattern was speculated to have been caused by sinus node dysfunction, and not by reduced fetal oxygenation in this case.

• 出版日期2015-12