| Congenital complete heart block: fetal management protocol, review of the literature, and report of the smallest successful pacemaker implantation. | |
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MedLine Citation:
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PMID: 14762451 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fetuses with complete heart block have an increased mortality with most deaths occurring in utero or during infancy. The cardiac evaluation of these fetuses is difficult since the ventricular rate is low and the heart is dilated. We have implemented a strategy that includes the biophysical profile, which assesses fetal well-being, in combination with the cardiovascular profile that assesses cardiac function and the circulation. We present two cases of fetal complete heart block in which early delivery was recommended due to worsening cardiovascular profile scores. Biophysical profile scores were normal. Both babies were successfully treated, despite having risk factors that predicted poor outcomes. We hypothesize that our management protocol initiated intervention before fetal compromise, hydrops, and myocardial damage occurred. We recommend an evaluation of heart function in addition to an assessment of fetal well-being in fetuses with complete heart block. Early delivery should be considered if there is evidence of distress and/or deteriorating cardiac function. |
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Authors:
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Mary T Donofrio; Scott D Gullquist; Inder D Mehta; William B Moskowitz |
Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 24 ISSN: 0743-8346 ISO Abbreviation: J Perinatol Publication Date: 2004 Feb |
Date Detail:
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Created Date: 2004-02-11 Completed Date: 2004-06-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
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Languages: eng Pagination: 112-7 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Division of Pediatric Cardiology, Medical College of Virginia Hospital of Virginia Commonwealth University, Richmond, VA 23298, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Clinical Protocols Dilatation, Pathologic Female Fetal Diseases / therapy*, ultrasonography Fetal Heart / ultrasonography Gestational Age Heart Block / congenital*, therapy*, ultrasonography Heart Ventricles / pathology Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases / therapy Pacemaker, Artificial Pregnancy Ultrasonography, Doppler Ultrasonography, Prenatal |
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