Intrapartum maternal sinus bradycardia with spontaneous resolution following delivery

Devendra K, Ching CK, Tan LK, Tan HK, Yu SL
Correspondence: Dr Devendra Kanagalingam, devendra.kanagalingam@sgh.com.sg

ABSTRACT
Pregnancy is a normal physiological state that is characterised by significant adaptive changes, many of which take place in the cardiovascular system. These adaptations are believed to be the cause for the increased incidence in cardiac arrhythmias in pregnancy and particularly, in labour. We report an unusual case of a healthy 32-year-old primigravida who developed profound intrapartum bradycardia which persisted throughout labour. Spontaneous recovery to pre-labour baseline heart rate occurred following spontaneous vaginal delivery. Maternal and foetal statuses remained satisfactory during labour. This case report underscores the importance of recognising that arrhythmias in various forms are common in labour. In the absence of detectable underlying cardiac disease or maternal and foetal compromise, continuation of the labour with a view to vaginal delivery should be the goal.

Keywords: arrhythmia, bradycardia, intrapartum material sinus bradycardia, pregnancy complications
Singapore Med J 2006; 47(11): 971-974