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Re: Embryonic Heart Rate @ 8 weeksFrom: Dianne Walkup (diannewalkup@hotmail.com)Wed Dec 4 20:19:15 2002
Greetings, Fetal arrythmia at 23 weeks depends on the arrythmia. Periodic slowing of the heart is a normal finding. A regular sustained heart rate of under 120 bears watching for a few minutes for resolution. A cardiac rate of over 200 rates a call for a fetal echocardiogram. Intermittant PVC's are not a normal finding, but can spontaneously resolve, and can be caused by maternal ingestion of substances from cocaine to caffeine. Any regularly spaced recurring PVC's or PAC's call for a referral for fetal echocardiogram. Slow heart rates under 80 or so are most times from some kind of heart block, common to patients with Lupus. The best course to follow is to evaluate the heart anatomy as thoroughly as you are able, paying careful attention to the orientation of the heart in the chest and any possible effusions. Sometimes in an anatomy scan the thing that catches your eye is a mildly abnormal cardiac axis. Next report your findings and refer the patient to the fetal echo experts in your area. It is better to be safe than sorry in these situations, because a baby with a known cardiac problem at birth will do much better than one with a surprise that has to be figured out in a hurry while the baby is in trouble.
-- Dianne Walkup, RDMS, RDCS mitakuye oyasin
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