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The aim – to evaluate the efficiency of prenatal echocardiography in detecting, differential diagnosis and monitoring fetuses with tachyarrhythmias. Materials and methods. Investigations performed in a single center from April 1996 to July 2016 were analysed. During this study 2,073 pregnant women were examined and 213 cases of fetal arrhythmia were found (10.3 %). Prenatal echocardiography was conducted by general protocol, each examination were fixed and saved in electronic and paper form. Results. During this period 25 cases of fetal tachyarrhythmias were diagnosed, representing 11.7 % of all cases of arrhythmia and 1.2 % of all fetal heart examinations. In five fetuses tachyarrhythmia was combined with structural heart disorders, which constitutes 20 % among all tachyarrhythmias. Most fetal tachyarrhythmias (21) were diagnosed during third trimester of pregnancy. The most common fetal tachyarrhythmia was atrioventricular «re-entry» tachycardia – 14 cases (56 %). None case of this group was combined with structural cardiac pathology, however, almost half were accompanied by hemodynamic complications. Drug treatment was effective in this group. Atrial fibrillation was second prevalent in our study, 4 cases (16 %) – dangerous arrhythmia, which in most fetuses caused circulatory failure, being combined with congenital heart defect or myocardial pathology. Drug treatment in this group is less effective, depending on comorbidity and age pregnancy. We diagnosed 4 cases of sinus tachycardia (16 %), largely having benign course in the prenatal period and not requiring drug treatment. Prognosis of pregnancy is determined by concomitant diseases of the fetus. One case (4 %) of atrial flutter required preterm delivery through the hemodynamic complications. Ectopic atrial tachycardia was diagnosed in two fetuses (8 %). This arrhythmia is insensitive to medical treatment and may persist after birth. Conclusions. Clinical management of pregnancy, the need for treatment and choice of effective antiarrhythmic drugs depends on the type of tachyarrhythmias. Prenatal echocardiography provides reliable monitoring of the fetus condition and effectiveness of antiarrhythmic treatment, determining the tactics during pregnancy, helps to plan childbirth and defines treatment after birth.

The aim was to study papillary muscles of the right ventricular septomarginal trabecula. Materials and methods: 98 formalinfixed normal hearts from human fetuses aged 17 to 28 weeks were studied by means stereomicroscope. Results. Muscles in such position were found to be in 55.1%. The free-standing papillary muscles predominated over the muscles of fixe type. The muscles had monolithic base, one belly and mostly one apex. Tendinous chords of these muscles entered only the septal cusp of the right atrioventricular valve. A potential clinical importance of the papillary muscles was mentioned. Conclusion. The papillary muscles situated at the septomarginal trabecula are proposed to regard as particular subgroup of septal papillary muscles.

Interventricular septum (IS) has been studied in ordinary formed human fetal hearts (20–28 weeks) by means of the anatomo-metrical method. VS breadth appears to be less than its length, but is more than the breadth of the medial walls of both ventricles. The outlet length surpasses the inlet one more on the right than on the left septal side. On transversal sections the angle between IS departments is 122 — 139°. The angle degree increases from the basis to the apex of the heart. The angle between the longest axes of the right surface divisions is 38 — 42°. The length proportions of the IS departments become constant to the middle fetal period. The sinus part of the IS is square or multiangular (often four- or five-angular) and along the bloodstream. The development of the sinus part is coordinated with formation of the inlet trabecular part. The conal part is the smallest one. The conal development in the middle fetal period has not been completed yet. Size proportions of the IS parts and departments seem to be much the same in the normal fetal and newborn hearts.

Fetal blood was collected in 83 women, 71 of these before abortions and in 12 of them with diagnostic purpose. Cardiocentesis was used in 31 cases, cordocentesis in 52. Obstetrical situation was analyzed and fetal heart beat recorded during the procedure. Blood group and rhesus appurtenance were determined in blood samples, Kleinhauer-Batke test was carried out, karyotype, HLA phenotype, and DNA analyzed. A positive result was found dependent on the adequate assessment of an obstetrical situation during fetal blood collection, as well as on equipment resolution power and physicians' experience. The possibility of practical use of cordo- and cardiocentesis is discussed with due consideration for these factors.