Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Obstetrics and Gynecology
Volume 2012, Article ID 406497, 3 pages
http://dx.doi.org/10.1155/2012/406497
Case Report

Blocked Atrial Bi/Trigeminy In Utero Evolving in Supraventricular Tachycardia after Birth

1Pediatric Cardiology, Sapienza University of Rome, Viale Regina Elena, 324, 00161 Rome, Italy
2Ultrasound Division, ASL Roma B, 00169 Rome, Italy
3Neonatal Pathology and NICU, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy

Received 27 March 2012; Accepted 20 June 2012

Academic Editors: B. Coroleu, A. Ohkuchi, and A. Semczuk

Copyright © 2012 V. Martucci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transient episodes of fetal bradycardia (heart rate less than 110 bpm) are usually benign and typically result from increased vagal stimulation in the fetus. Causes of sustained fetal bradycardia include sinus bradycardia, blocked atrial bigeminy/trigeminy, high-degree atrioventricular block, and long QT syndrome. We present the case of a 34-year-old Caucasian patient referred to our department for “blocked atrial bigeminy with pseudobradycardia” detected elsewhere at 33 weeks of gestation. A fetal echocardiography showed during all the examination a blocked atrial trigeminy with a mean fetal heart rate of 100 bpm. After birth three subsequent ECGs until day 3 showed no evidence of atrial extrasystoles, confirming the well-known frequent regression of this kind of fetal benign arrhythmia, but on day 11 recurrence of supraventricular trigeminy and development of episodes of paroxystic supraventricular tachycardia were observed. On the basis of this observation, we recommend that fetuses with complex atrial ectopic beats should be closely monitored before and after birth for evidence of new arrhythmias.