Role of fetal echocardiography in the management of isolated fetal heart block with ventricular rate < 55BPM

Persistent bradycardia is an uncommon cardiac problem in fetuses but carrie s a high mortality in those with a ventricular rate less than 55 bpm. Fetal heart block is one of the most common causes of persistent fetal bradycard ia (PFB). An optimal method for assessing and monitoring cardiovascular com pensation in the setting of PFB due to heart block has not been fully estab lished. We report the application of two-dimensional and Doppler echocardio graphy in close monitoring of cardiac function and hemodynamics in a third- trimester fetus with a ventricular rate less than 55 bpm due to heart block , which assisted in successful management of the pregnancy to term. Hemodyn amic and cardiac adaptive changes in compromised fetuses, particularly due to heart block, are discussed.