دورية أكاديمية
أعرض في EDS

Implications of fetal premature atrial contractions: systematic review.

التفاصيل البيبلوغرافية
العنوان: Implications of fetal premature atrial contractions: systematic review.
المؤلفون: Bet BB; Department of Obstetrics and Gynaecology, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Reproduction and Development, Amsterdam, The Netherlands., De Vries JM; Department of Obstetrics and Gynaecology, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Reproduction and Development, Amsterdam, The Netherlands., Limpens J; Medical Library, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands., Van Wely M; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.; Centre for Reproductive Medicine, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands., Van Leeuwen E; Department of Obstetrics and Gynaecology, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Reproduction and Development, Amsterdam, The Netherlands., Clur SA; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.; Department of Pediatric Cardiology, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands., Pajkrt E; Department of Obstetrics and Gynaecology, Amsterdam UMC location, University of Amsterdam, Amsterdam, The Netherlands.; Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
المصدر: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology [Ultrasound Obstet Gynecol] 2022 Dec; Vol. 60 (6), pp. 721-730.
نوع المنشور: Systematic Review; Meta-Analysis; Journal Article; Review
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Ltd Country of Publication: England NLM ID: 9108340 Publication Model: Print Cited Medium: Internet ISSN: 1469-0705 (Electronic) Linking ISSN: 09607692 NLM ISO Abbreviation: Ultrasound Obstet Gynecol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2003- : Chichester, West Sussex, UK : John Wiley & Sons, Ltd.
Original Publication: Carnforth, Lancs, UK ; Park Ridge, N.J., USA : Parthenon Pub., c1991-
مواضيع طبية MeSH: Fetal Diseases*/diagnostic imaging , Fetal Diseases*/epidemiology , Premature Birth*/epidemiology , Atrial Premature Complexes*/epidemiology , Heart Failure*, Pregnancy ; Female ; Humans ; Fetal Death/etiology ; Fetus ; Tachycardia ; Arrhythmias, Cardiac
مستخلص: Objective: Fetal heart-rate irregularities occur in 1-2% of pregnancies and are usually caused by premature atrial contractions (PAC). Although PAC are considered benign, they may be associated with cardiac defects and tachyarrhythmia. We aimed to determine the incidence of congenital heart defects (CHDs) and complications in fetuses with PAC.
Methods: This was a systematic review and meta-analysis conducted in accordance with the PRISMA statement for reporting items for systematic reviews and meta-analyses. MEDLINE and EMBASE were searched from 1990 to June 2021 to identify studies on fetuses with PAC. The primary outcome was CHD; secondary outcomes were complications using the endpoints supraventricular tachyarrhythmia (SVT), cardiac failure and intrauterine fetal demise. Meta-analysis of proportions was performed, subdivided into high-risk and low-risk populations based on reason for referral. Pooled incidences with 95% CIs were calculated.
Results: Of 2443 unique articles identified, 19 cohort studies including 2260 fetuses were included. The pooled incidence of CHD in fetuses with PAC was 2.8% (95% CI, 1.5-4.1%), when 0.6% is the incidence expected in the general population. The pooled incidence of CHD was 7.2% (95% CI, 3.5-10.9%) in the high-risk population and 0.9% (95% CI, 0.0-2.0%) in the low-risk population. SVT occurred in 1.4% (95% CI, 0.6-3.4%) of fetuses diagnosed with PAC. Cardiac failure was described in 16 fetuses (1.4% (95% CI, 0.5-3.5%)), of which eight were CHD-related. Intrauterine fetal demise occurred in four fetuses (0.9% (95% CI, 0.5-1.7%)) and was related to CHD in two cases.
Conclusions: Our findings suggest that the risk of CHD in fetuses with PAC is 4-5 times higher than that in the general population. CHD was present more frequently in the high-risk population. Consequently, an advanced ultrasound examination to diagnose PAC correctly and exclude CHD is recommended. Complications of PAC are rare but can result in fetal demise, thus weekly fetal heart-rate monitoring remains advisable to enable early detection of SVT and to prevent cardiac failure. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
(© 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.)
التعليقات: Comment in: Ultrasound Obstet Gynecol. 2022 Dec;60(6):717-720. doi: 10.1002/uog.26109. (PMID: 36454638)
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فهرسة مساهمة: Keywords: adverse pregnancy outcome; congenital heart defect; fetal arrhythmia; premature atrial contractions; supraventricular tachyarrhythmia
تواريخ الأحداث: Date Created: 20220628 Date Completed: 20221205 Latest Revision: 20240916
رمز التحديث: 20240916
مُعرف محوري في PubMed: PMC10107702
DOI: 10.1002/uog.26017
PMID: 35763619
قاعدة البيانات: MEDLINE
الوصف
تدمد:1469-0705
DOI:10.1002/uog.26017