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| The value of cardiovascular overall scores in fetal arrhythmia |
| ZHANG Wen, ZHU Qi, CHEN Jiao, GUO Nan, LIU Dan, WU Ting, DAI Xiao-hui, LUO Hong |
Department of Ultrasound, West China Second Hospital, Sichuan University, Key Laboratory of Birth Defects and
Related Women and Children's Diseases, Ministry of Education, Chengdu 610041, China |
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Abstract Objective: To study the type and incidence of fetal arrhythmia by prenatal ultrasound and to explore the value of Cardiovascular profile scores(CVPS) in fetal arrhythmias. Method: 295 cases which were diagnosed with fetal arrhythmia and got further examination in Department of Ultrasound of West China Second Hospital of Sichuan University from January 2008 to January 2018 were recruited. Stratified according to CVPS scores, we summarized the type of fetal arrhythmia, the type of intra-cardiac and extra-cardiac malformation and analyzed the prognosis of these fetuses. Results: The average age of 295 pregnant women was 27.4±5.6 years, and the average gestational age was 30.6±4.9 weeks. Among them, there were 0 fetuses with a CVPS score less than 4, and there were 1, 9, 15, 21, 34, 48 and 167 fetuses with a CVPS score between 4 and 10, respectively. Among them, there were 190 cases(64.4%) of atrial arrhythmia, 28 cases(9.5%) of ventricular arrhythmia, 28 cases(9.5%) of supraventricular tachycardia, 39 cases(13.2%) with atrioventricular conduction block and 15 cases(5.1%) with sinus bradycardia. 51(17.3%) fetuses had intra-cardiac malformations, 14(4.7%) had extra-cardiac malformations. 54 cases(18.3%) were in the adverse pregnancy outcome group and 210 cases(71.2%) were in the live birth group, but 31 cases(10.5%) were lost to follow up. ROC curve analysis showed that the area under the curve(AUC) was 0.754, and the cut-off value of 8.5(P<0.05) in the live birth group and the adverse pregnancy outcome group, with a sensitivity of 82.4% and a specificity of 59.3%. Conclusion: In fetal arrhythmias, atrial arrhythmia accounts for the majority, which is similar to ventricular arrhythmia, CVPS scores of both are higher, and the prognosis of both can be better. For the fetus who has a significantly lower CVPS score, the incidence of complicated intra-cardiac and extra-cardiac malformations and adverse pregnancy outcome is relatively higher. Therefore, the fetal CVPS has important guiding significance for the prediction of fetal arrhythmia pregnancy outcome.
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Received: 20 October 2018
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2019, Vol. 30 
