No abstract

Objectives

Fetal echocardiography can provide useful information for the evaluation of fetal arrhythmias. Between 1980 and 1993, 44 fetuses with arrhythmias were diagnosed in utero at 12 and 40 weeks of gestation in Kurume University Hospital. Fetal bradycardia, tachycardia and ectopic beats were revealed in 17, seven and 20 fetuses, respectively, and their clinical features and prognosis were evaluated. In the 17 fetuses with bradycardia, eight were associated with congenital heart defect, and six of these developed to fetal hydrops. Of the 17 fetuses, four died in utero, one was terminated, and six died after birth. The other six cases survived. Three of these had a pacemaker implanted after birth. In the seven fetuses with tachycardia, transplacental anti‐arrhythmic drugs were administered in five cases and conversion of the arrhythmia was achieved in four. None of the cases was associated with any congenital heart defect, and none died. Three infants had paroxysmal tachycardia postnatally. In the 20 fetuses with ectopic beats, arrhythmia was observed postnatally in 10, but all of these were resolved within 3 months after birth. Fetal bradycardias carried a poor prognosis in most cases and further studies are required to establish effective treatment. Some cases of fetal tachycardia developed recurrent tachycardia postnatally. Close follow‐up of the newborn is therefore necessary.

Aim Breast milk (BM) contains various protective components, such as immunoglobulins, lactoferrin, lysozyme, oligosaccharides and immune cell subsets. We evaluated the effectiveness of BM eye drops in infants with eye discharge in a randomised controlled study. Methods Subjects were breastfed infants aged ≤180 days, with eye discharge. We randomly assigned patients to receive eye drops of BM or sodium azulene sulphonate hydrate 0.02% ophthalmic solution (OS). The patients received drop of BM or OS for 7 days. Improvement score of eye discharge in the groups was compared using a non‐inferiority test. Results The number of patients improved eye discharge was 119/155 (76.8%) and 119/157 (75.8%) in BM and OS groups, respectively. There were no significant differences between groups. The improvement score in eye discharge was 1.76 ± 0.91 in the BM group and 1.71 ± 0.96 in the OS group. The BM group was considered non‐inferior to the OS group. Conclusions This study demonstrated that BM is no less effective than OS in infants with eye discharge aged ≤6 months. The results suggested that the use of breast milk as eye drops could be considered as a first‐line treatment for infants aged ≤6 months with eye discharge.

Recent advances in echocardiography have allowed the anatomical structure of the fetal heart to be successfully and safely seen in details. It has since enabled not only the prenatal diagnosis of congenital heart disease but the diagnosis and treatment of fetal arrhythmias. New advances of Doppler echocardiography have provided exciting informations on the fetal physiology of normal or abnormal fetal circulation. We have performed the fetal echocardiography from 1980 on 564 fetuses which comprised 254 normal and 310 high risk pregnacies. From our experiences we discuss the prenatal diagnosis of congenital heart disease and its method and accuracy, the recognition and intrauterine treatment of fetal arrhythmias, the diagnosis of fetal heart failure, the assessment or research of fetal circulation by Doppler echocardiography, and finally the management for the fetus with cardiac problems and the ethical issue in fetal cardiology.