Objective: In a review of 64 fetuses with ectopic premature contraction, our objectives were to estimate the incidence of structural heart defects and fetal compromise, to evaluate the natural course of these arrhythmias and the intrauterine management, and assess the perinatal and long-term outcomes.
Methods: We review the medical records of pregnant women diagnosed with fetal ectopic premature contraction at Asan Medical Center from July 1996 to December 2003. The ectopic premature contractions were classified as either premature atrial contraction (PAC) or premature ventricular contraction (PVC), and the outcomes of the infants were analyzed.
Results: Among 59 fetuses with PAC, it was possible to determine the final outcome for 37 of them. A normal heart rhythm was achieved during pregnancy in 7 fetuses and after birth in 28. One fetus developed supraventricular tachycardia postnatally and require medication. One fetus was diagnosed with a partial mole and the pregnancy was terminated. In the PAC group, there was one structural heart defect (VSD) and no remarkable findings regarding perinatal outcome. Among 5 fetuses with PVC, 1 fetus showed a normal heart rhythm during pregnancy and 2 after birth. One fetus showed a small amount of pericardial effusion and was terminated at other hospital against our recommendation. In the other case, VSD and PDA were diagnosed postnatally and the PVC disappeared three months after birth without treatment.
Conclusion: Isolated ectopic premature contractions, including PAC and PVC, resolve spontaneously either prenatally or early in the postnatal period and should not be considered risk factors for cardiac anomalies or poor perinatal outcome.