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Maternal and Fetal Cardiovascular Disease pp 201–212Cite as

Fetal Cardiac Disease

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Abstract

The optimal management of pregnancies involving fetal congenital anomalies is important because the events of perinatal period are strongly associated with perioperative mortality and long-term outcomes. Congenital heart disease (CHD) is one of the most prominent birth defects; however, few reports on obstetrical issues in pregnancy with fetal CHD have been published. In this chapter, we review antenatal and intrapartum management for fetuses with CHD focusing particularly on intrapartum electrical fetal heart rate (FHR) monitoring in CHD patients.

FHR monitoring has been widely used for antenatal and intrapartum management. Our previous study demonstrated that fetuses with structural heart anomalies tended to show variant heart rate patterns such as severe variable deceleration, recurrent late deceleration, prolonged deceleration, and loss of baseline variability. Single ventricle, isomerism, and tetralogy of Fallot frequently showed variant FHR patterns. Conversely, umbilical artery pH results showed that most CHD fetuses with variant FHR patterns did not have accompanying acidosis, even in cases of emergency Caesarean section (C-section). These data suggested that special consideration is needed when translating the findings of aberrant FHR patterns in fetuses with CHD. Although FHR monitoring is among the most validated tools to detect nonreassuring fetal status, additional strategies should be discussed in the future due to the difficulty of monitoring fetal well-being in CHD patients.

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Authors and Affiliations

  1. Clinical Research Support Center, The University of Tokyo, Tokyo, Japan

    Keiko Ueda

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  1. Keiko Ueda
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Correspondence to Keiko Ueda .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie, Japan

    Tomoaki Ikeda

  2. Department of Perinatology and Gynecology, National Cerebral and Cardiovascul Center, Suita, Osaka, Japan

    Chizuko Aoki-Kamiya

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Ueda, K. (2019). Fetal Cardiac Disease. In: Ikeda, T., Aoki-Kamiya, C. (eds) Maternal and Fetal Cardiovascular Disease. Springer, Singapore. https://doi.org/10.1007/978-981-10-1993-7_17

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  • DOI: https://doi.org/10.1007/978-981-10-1993-7_17

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-1991-3

  • Online ISBN: 978-981-10-1993-7

  • eBook Packages: MedicineMedicine (R0)

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