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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
Summary
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.
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