[Prenatal diagnosis of arrhythmias and associated congenital cardiac abnormalities using ultrasonography].

Cardiac arrhythmias are one of the most frequent indications for a 2D and Doppler fetal echocardiographic assessment (DE). If accompanied by a non-immune fetal hydrops, arrhythmias (A) involve an increased risk of intrauterine death. Some A and mainly the bradyarrhythmias (BA) can be the first sign of major cardiac malformation (CM). In a series of 404 pregnancies between week 17 and 40 of gestation (mean 27.6 weeks), a Doppler echocardiography was carried out; in 137 (35%) fetuses (F) this examination was based on the indication of arrhythmia. 33 (24.2%) of these fetuses showed a cardiac malformation. Bradyarrhythmias were found in 20 F; 5 had a complete AV-block including, 4 with an important cardiac abnormality (TU, complete AV-canal, corr. TGV). SVT's and auricular flutters (AF) made transplacental treatment necessary in 4 fetuses (1 AF, 3 SVT); they had no major cardiac malformation. PAC's were present in 59 pregnancies of which several had minor or major anomalies. Doppler echocardiography served to define the arrhythmia and the structural cardiac malformation, but also to follow transplacental treatment. These investigations have allowed us to schedule delivery under neonatal surveillance. After birth, 5 neonates had to be treated for persistent dysrhythmia (5 SVT, 2 complete AB-blocks), and 10 for a major cardiac malformation.