High-Risk Pregnancy

Cardiac Arrhythmia

I've never posted on this board before, but thought I'd see if anyone else has had a similar experience! I can already tell you this will be quite long, so thanks to anyone who can bear with me. :)

I'm 29 weeks along, and at our 20 wk ultrasound they found out that our son has an  arrhythmia - his heart beat is very irregular because of PACs. His overall heart rate is 120's-130's but the ventricular rate is usually in the 80's (meaning that only those beats are actually pumping blood to the brain and body). I'm a telemetry nurse and I deal with patients with cardiac issues all the time, so I feel like I understand what's going on with the baby and I'm not too freaked out about it. However, it's my BABY and I deal with adults, not the fetal side of things.

We have definitely been getting the proper follow up - growth ultrasounds every 3 weeks to make sure that he's still moving right along despite the whole thing (this is done at the hospital and a high-risk OB comes and reviews it with us each time), and we had a fetal echocardiogram done and saw a pediatric cardiologist. We got back to see him in a couple of weeks for another echo and to make sure everything is still going ok. This is in addition to our check ups with our regular OB.

When we saw the cardiologist he had mentioned that I may need to deliver by c-section because the arrhythmia may make it hard to monitor the baby during labor. Makes total sense to me based on what I learned in nursing school about the fetal heart rate monitoring they do - if it's so irregular who knows what the tracing would look like and whether they would be able to tell if the baby is in distress. So he said to ask our regular OB about it, because it would be up to him. 

Here's the thing that freaks me out a *little*...I'm perfectly ok with whatever type of delivery will be best for the baby, so at my OB appt today, I told him what the cardiologist said about the possibility of a c-section. He asked how I felt about it and I said I want to do whatever is safest. Then he said that I should ask the high-risk OB about it at our next growth ultrasound because he wasn't sure. He said I'm definitely not the first person to have this issue, but I'm the first in their practice. This was pretty surprising to me because there are 6 or 7 doctors in the practice and they've all been around for a *while* (like decades)...and none of them has ever had a patient with a fetal arrhythmia? I know arrhythmia's aren't super common, but I know my baby has the most common type.

I *LOVE* my doctor - I watched him deliver by BFF's baby 18 mos ago so I've seen how he works, plus when I was in clinicals in nursing school he had a great reputation with everyone at the hospital - very friendly but professional, never said a bad word about a patient (unlike so many of the others) and I have over all been impressed with the care we've received from him. So I guess my question is, would you be worried about being in uncharted territory as far as your doctor is concerned? We have all the right people collaborating - cardiology and high-risk OB (who will also be accessible at the hospital at the time of delivery). Any thoughts?

TIA!

 

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Re: Cardiac Arrhythmia

  • First off-congrats on the one to come :)  Now on to the big stuff...I completely understand where you are coming from, where its different when it comes to YOUR baby instead of what you see everyday.  I'm a NICU nurse, have dabbled in L&D and have seen this before.  Its not uncommon for babies to have arrhythmias, most clear up on their own or can be correctly fairly easily.  Also, during your labor process, the OB can put internals in (a scalp electrode) if necessary to monitor the heart rate better if the dopplers have a tough time.  And lastly, I wouldn't worry so much about the OB doctor and his expertise in the field as I would the Pediatrician or Neonatologist.  The concern is with your baby and how it deals with labor and then once delivered. You can always talk to another OB (sometimes the newest ones are the best because of all the new technology and studies, and the old docs get kind of set in their ways) and just make sure that your OB is on the right page.  Good luck on what you decide :)
  • Thanks for your reply! Hopefully the perinatologist can tell me what kind of success they've had with monitoring during labor and successful vag deliveries in cases like mine. We'll get to ask all our questions on Monday!
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