Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Profound Fetal Bradycardia: A Case Report Highlighting Treatment Options

Journal of Perinatology volume 23, pages 509–512 (2003)Cite this article

Abstract

A case report of a fetus that presented at 33 weeks gestation with profound bradycardia associated with ventricular rates of <50 beats per minute. Possible management strategies include continued observation, medical intervention of the mother with stimulants and urgent delivery of the fetus. The differential diagnosis, management and ultimate course of this patient are discussed.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Buyon JP, Heibert R, Copel J, et al. Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol 1998;31:1658–1666.

    Article  CAS  Google Scholar 

  2. Carreira PE, Gutierrez-Larraya F, Gomez-Reino JJ . Successful intrauterine therapy with dexamethasone for fetal myocarditis and heart block in a woman with systemic lupus erythematosus. J Rheumatol 1993;20:1204–1207.

    CAS  PubMed  Google Scholar 

  3. Shinohara K, Miyagawa S, Fujita T, Aono T, Kidoguchi K . Neonatal lupus erythematosus: results of maternal corticosteroid therapy. Obstet Gynecol 1999;93:952–957.

    CAS  PubMed  Google Scholar 

  4. Watson WJ, Katz VL . Steroid therapy for hydrops associated with antibody-mediated congenital heart block. Am J Obstet Gynecol 1991;165:553–554.

    Article  CAS  Google Scholar 

  5. Barclay CS, French MA, Ross LD, Sokol RJ . Successful pregnancy following steroid therapy and plasma exchange in a woman with anti-Ro (SS-A) antibodies. Case report. Br J Obstet Gynaecol 1987;94:369–371.

    Article  CAS  Google Scholar 

  6. Rosenthal D, Druzin M, Chin C, Dubin A . A new therapeutic approach to the fetus with congenital complete heart block: preemptive, targeted therapy with dexamethasone. Obstet Gynecol 1998;92:689–691.

    CAS  PubMed  Google Scholar 

  7. Saleeb S, Copel J, Friedman D, Buyon JP . Comparison of treatment with fluorinated glucocorticoids to the natural history of autoantibody-associated congenital heart block: Retrospective review of the research registry for neonatal lupus. Arthritis Rheum 1999;42:2335–2345.

    Article  CAS  Google Scholar 

  8. Huang HW, Chang SY, Changchien CC, Hsu YH, Hsu TY . Prenatal diagnosis of persistent fetal bradycardia: report of four cases. Chang Gung Med J 2001;24:57–61.

    CAS  PubMed  Google Scholar 

  9. Rasanen J . The effects of ritodrine infusion on fetal myocardial function and fetal hemodynamics. Acta Obstet Gynecol Scand 1990;69:487–492.

    Article  CAS  Google Scholar 

  10. Litsey SE, Noonan JA, O'Connor WN, Cottrill CM, Mitchell B . Maternal connective tissue disease and congenital heart block: demonstration of immunoglobulin in cardiac tissue. N Engl J Med 1985;312:98–100.

    Article  CAS  Google Scholar 

  11. Michaelsson M, Riesenfeld T, Jonzon A . Natural history of congenital complete atrioventricular block. Pacing Clin Electrophysiol 1997;20:2098–2101.

    Article  CAS  Google Scholar 

  12. Priori SG, Napolitano C, Schwartz PJ . Low penetrance in the long-QT syndrome: clinical impact. Circulation 1999;99:529–533.

    Article  CAS  Google Scholar 

  13. Hofbeck M, Ulmer H, Beinder E, Sieber E, Singer A . Prenatal findings in patients with prolonged QT interval in the neonatal period. Heart 1997;77:198–204.

    Article  CAS  Google Scholar 

  14. Fish FA, Benson Jr DW . Disorders of cardiac rhythm and conduction. In: Allen HD, Gutgesell HP, Clark EB, Driscoll DJ, editors. Moss and Adams' Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young adult. 6th ed. Philadelphia: Lippincott, Williams & Wilkins; 2001. p. 524.

    Google Scholar 

  15. Rein AJ, Cohen E, Weiss A, Marks KA, Peleg O, Nir A . Noninvasive external pacing in the newborn. Pediatr Cardiol 1999;20:290–292.

    Article  CAS  Google Scholar 

  16. Hanseus K, Sandstrom S, Schuller H . Emergency pacing and subsequent permanent pacemaker implantation in a premature infant of 1770 g with a follow-up of 6 years. Pediatr Cardiol 2000;21:470–473.

    Article  CAS  Google Scholar 

  17. Nowak B, Kampmann C, Schmid FX, et al. Pacemaker therapy in premature children with high degree AV block. Pacing Clin Electrophysiol 1998;21:2695–2698.

    Article  CAS  Google Scholar 

  18. Ohmi M, Tofukuji M, Sato K, et al. Permanent pacemaker implantation in premature infants less than 2000 grams of body weight. Ann Thorac Surg 1992;54:1223–1225.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We acknowledge the assistance of Barbara S. Reich and the staff of the Hackensack University Medical Center Library in the preparation of this article.

Author information

Authors and Affiliations

  1. Division of Pediatric Cardiology, Hackensack University Medical Center, NJ, USA

    Robert J Tozzi MD, Cheryl C Kurer MD & George Kipel MD

Authors
  1. Robert J Tozzi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheryl C Kurer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George Kipel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tozzi, R., Kurer, C. & Kipel, G. Profound Fetal Bradycardia: A Case Report Highlighting Treatment Options. J Perinatol 23, 509–512 (2003). https://doi.org/10.1038/sj.jp.7210938

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7210938

This article is cited by

Search

Advanced search

Quick links