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Complete congenital foetal heart block: a case report

M Dey1, T Jose1, A Shrivastava1

  • 1Department of Obstetrics and Gynaecology, Armed Forces Medical College, Pune, Maharashtra, India - 411040.

Facts, Views & Vision in Obgyn
|July 11, 2014
PubMed

Insights

Congenital heart block (CHB), a severe neonatal lupus complication, can lead to lethal atrioventricular (AV) block. This case highlights a favorable outcome in fetal complete CHB associated with high maternal anti-Ro/SSA and anti-La/SSB antibody titers.

Area of Science:

  • Immunology
  • Cardiology
  • Neonatology

Background:

  • Congenital heart block (CHB) is the most severe manifestation of neonatal lupus.
  • It can progress to a lethal atrioventricular (AV) block, typically developing between 20-24 weeks gestation.
  • CHB in fetuses with structurally normal hearts is often linked to maternal autoantibodies, specifically anti-Ro/SSA and anti-La/SSB.

Observation:

  • This report details a case of fetal complete CHB.
  • The case involved a mother with high titers of anti-Ro/SSA and anti-La/SSB autoantibodies.
  • The fetal outcome was favorable despite the high antibody levels.

Findings:

  • Maternal autoantibodies (anti-Ro/SSA and anti-La/SSB) are strongly associated with CHB.
  • High titers of these antibodies were present in the reported case.
  • Successful management or natural resolution led to a favorable fetal outcome.

Implications:

  • This case suggests that even with high maternal autoantibody titers, a favorable outcome for fetal CHB is possible.
  • It underscores the importance of monitoring and potentially managing pregnancies with maternal autoantibodies.
  • Further research into the mechanisms and management of CHB in neonatal lupus is warranted.

Keywords:
Congenital heart blockDexamethasoneLa/SSBRo/SSASLE

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