【摘要】 胎儿心律失常(FA)是产科及儿童心血管科门诊常见的胎儿疾病，约10%FA可持续存在或进展，导致重要脏器继发性损伤及胎儿心力衰竭，甚至可导致胎儿早产及死亡。在准确的产前诊断基础上，对FA的性质进行甄别，对严重FA进行及时恰当干预，改善胎儿预后，具有极大的医学及社会学意义。目前国外在FA产前干预方案制定，以及治疗药物评价等方面均取得较多进展，但是国内相关研究尚较少，不同研究对FA的产前治疗及管理差异均较大。为提高中国儿科及围生医学科医师对FA产前管理认识，严格把控FA临床治疗适应证，规范治疗策略，推动FA产前干预在国内的健康良性发展，中华医学会儿科学分会心血管学组胎儿心脏病协作组、围产期先天性心脏病诊疗协作组组织相关专家，结合国内外FA产前治疗及管理的最新研究进展与国内实际，经过充分讨论，对我国FA产前干预指征、干预策略、药物治疗选择等，达成初步共识后，制定《胎儿心律失常产前治疗及管理专家指导意见》。但是，目前国外关于快速及缓慢性FA产前干预的临床研究，多局限于单中心、回顾性及小样本研究，不同研究的干预方案差异较大，临床证据级别较低。随着国内外FA产前干预工作的进一步发展，部分多中心、前瞻性随机对照临床试验研究数据的发布，在国内同道共同努力下，本意见内容将不断更新、完善，也将更符合国内临床实践需求，达到促进FA产前治疗及管理不断进步的目的。更多还原

【Abstract】 Fetal arrhythmias(FA) are common cardiac disorders in clinics of obstetrics and pediatric cardiology. Approximately 10% FA could persist or even progress, which may result in secondary organ injury, such as fetal heart failure, fetal premature delivery or even fetal demise. Based on accurate prenatal diagnosis of FA, reasonable classification and timely intervention for severely affected fetuses could improve prognosis of FA, which has great medical and sociological significance. Despite much progress have been achieved in field of prenatal management of FA in foreign countries, there are a few relevant studies in China. Moreover, there are great differences in prenatal management strategies for FA among different medical centers. In order to improve understanding of perinatal management of FA for obstetricians and pediatricians, standardize the intervention indications and treatment strategies, and promote the benign development of prenatal intervention for FA in China, experts from the Fetal and Perinatal Heart Disease Cooperation Team of Pediatric Cardiovascular Group of Chinese Pediatric Society, Chinese Medial Association put forward the Expert Guidance on Prenatal Treatment and Management for Fetal Arrhythmia after full discussion on prenatal intervention indications, treatment strategies as well as details of medicines selections according to the latest research progresses and current domestic situations. However, relevant clinical studies are limited to single-center, retrospective, and small sample size studies and the conclusions differed among different studies. Furthermore, only a minority of data were from China. Therefore, the evidences level are not so high. With further development of prenatal intervention for FA, the release of data from several multiple-centers, prospective and randomized controlled clinical studies, and with joint efforts of domestic clinicians, the content of this guidance will continue to be update and improved, and it will also be more in line with the actual domestic clinical practice needs, to achieve the goal of promoting continuous improvement of prenatal treatment and management of FA.更多还原