Fetal electrocardiography and cardioversion with direct current countershock. Report of a case.

MAR\~N L. MEITUS, M.D., P.C.C.P. Miami Beach, Florida THE FIRST FETAL ELECTROCARDIOGRAM in utero was obtained by Cremer,' in 1906. Of the clinical applications of fetal electrocardiography described in the literature, the following are included: 1. Confirmation of fetal life in utero. 2. Detection of early (first-trimester) pre.pancy. 3. Proof of multiple pregnancy. 4. Dia~pmis of fetal position. 5. Prenatal detection of congenital heart dixase. 6. Contint~ous monitor in^ of the fet.11 heart during labor. 7. Postmatorit) or fetal anoxia. 8. Dia,pmis of fetal arrhythmias. D i r d e n of the maternal heart beat during pregnancy may develop in the presence or absence of organic heart disease. Sinus tachycardia. parox!smal supraventricular tachycardia. atrial flutter and atrial fibrillation may precipitate severe heart failure. There have been instances of fetal distress and of intra-uterine death attributed to intrapartum hypoxii~ asociated with impairment of the circulation in parox\xmal tachycardia and arrhythmias.' Pre<pancies 'romplicated by rheumatic heart disease and paroxysmal or established atrial fibrillation have been analyzed.' The incidence of heart failure and emhnlic episodes was higher in the atrial fibrillation