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目的:总结胎儿心律失常原因,进一步探讨胎儿心律失常对胎儿预后的影响。方法:采用回顾性分析方法,对21例胎儿心律失常孕妇的情况,胎儿心律失常的临床表现、诊断方法,结合长期随诊结果进行总结。结果:胎儿心律失常的发生率为0.3%。21例胎儿心律失常中,4例为胎儿心动过:速(19.0%),3例为胎儿心动过缓(14.3%),14例为不规则胎儿心律(67.7%);胎儿心律失常平均诊断孕周岁36+2周(28周~41+1周)。21例中18例为产前胎心听诊时发现胎儿心律失常;3例胎心监测发现胎儿心律失常。6例产前进行了胎儿超声心动检查,其中2例胎儿超声心动检查提示胎儿室性早搏,心脏结构未见异常,占33.3%,余未见异常。产后新生儿均存活,随诊20例(95.2%),10例新生儿进行了超声心动检查,其中1例诊断为先天性心脏病,为法洛四联症。先天性心脏病新生儿在心律失常胎儿中发生率为4.8%。结论:大多数心律失常的胎儿预后是好的,心脏畸形的发生率很低。对于持续性心率慢的胎儿,需注意心脏结构异常的存在;对于心律失常胎儿的处理采用期待疗法,根据产科指征决定终止妊娠的方式。
Objective: To summarize the causes of fetal arrhythmia and further explore the impact of fetal arrhythmia on fetal prognosis. Methods: A retrospective analysis of 21 cases of fetal arrhythmia in pregnant women, clinical manifestations of fetal arrhythmia, diagnostic methods, combined with long-term follow-up results were summarized. Results: The incidence of fetal arrhythmia was 0.3%. Of the 21 fetuses with fetal arrhythmias, 4 were fetal heartbeat (19.0%), 3 were fetal bradycardia (14.3%), and 14 were irregular fetal heart rhythms (67.7%). The average diagnosis of fetal arrhythmia Aged 36 + 2 weeks (28 weeks ~ 41 + 1 week). Among the 21 cases, 18 cases were found to have fetal arrhythmia during antenatal fetal heartbeat. Three cases of fetal heart rate monitor found fetal arrhythmia. 6 cases of prenatal fetal echocardiography, 2 cases of fetal echocardiography showed premature ventricular premature beats, no abnormal heart structure, accounting for 33.3%, I have not seen any abnormalities. Postpartum neonates were alive, followed up in 20 cases (95.2%), 10 newborns echocardiography, of which 1 case was diagnosed as congenital heart disease, tetralogy of Fallot. Congenital heart disease neonatal incidence of arrhythmia fetus was 4.8%. Conclusions: Most arrhythmias have a good fetal prognosis and a very low incidence of cardiac abnormalities. For the fetus with persistent heart rate slow, pay attention to the existence of cardiac structural abnormalities; for the treatment of arrhythmic fetuses expectant therapy, according to obstetric indications decided to terminate the pregnancy.