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Congenital atrioventricular block: histological aspects.
M D Piercecchi-Marti1, H Mohamed, C Chau
1Service de Médecine Légale, CHU Timone 264 rue Saint-Pierre, 13005, Marseille, France. mpiercecchi@ap-hm.fr
Forensic Science International
|September 13, 2003
Summary
Maternal autoimmune diseases like lupus can cause fetal heart block. Histological examination revealed specific cardiac lesions, highlighting the importance of diagnosing these conditions in unexplained fetal deaths.
Area of Science:
- Cardiovascular Pathology
- Maternal-Fetal Medicine
- Immunology
Background:
- Maternal autoimmune diseases are implicated in fetal cardiac conduction defects.
- Histological changes in the fetal conduction system are not well-documented.
Observation:
- A 33-year-old woman with a history of photosensitivity (suggesting systemic lupus erythematosus) presented with a fetus diagnosed with complete atrioventricular block.
- Fetal death occurred at 29 weeks gestation despite maternal prednisone treatment.
- The fetus tested positive for anti-SSA and anti-SSB antibodies.
Findings:
- Histological examination of the fetal heart revealed an altered atrioventricular node and bundle of His.
- Lesions included fibrosis, calcifications, endocardial fibroelastosis, and mononucleated inflammatory cells.
Implications:
- Identifying these specific cardiac lesions is crucial for understanding the pathogenesis of fetal heart block.
- Diagnosing maternal autoimmune disease is vital in cases of unexplained fetal death to prevent recurrence.