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Fetal complete heart block.

M V Machado1, M J Tynan, P V Curry

  • 1Department of Perinatal Cardiology, Guy's Hospital, London.

British Heart Journal
|December 1, 1988
PubMed
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Fetal complete heart block, often linked to maternal Sjögren A antibody (Ro), has better outcomes when isolated. Associated structural heart defects significantly worsen prognosis, impacting survival rates and pacemaker needs.

Area of Science:

  • Cardiology
  • Pediatrics
  • Immunology

Background:

  • Fetal complete heart block (FCHB) is a rare but serious condition.
  • Maternal autoantibodies, particularly anti-Ro/SSA, are implicated in FCHB pathogenesis.
  • The association between FCHB and congenital heart disease (CHD) requires further investigation.

Purpose of the Study:

  • To investigate the incidence and clinical characteristics of FCHB.
  • To determine the association between FCHB and structural heart disease.
  • To evaluate the outcomes of fetuses with isolated versus syndromic FCHB.

Main Methods:

  • Retrospective analysis of fetal echocardiography referrals over eight years.
  • Identification of 37 fetuses with complete heart block.

Related Experiment Videos

  • Correlation of FCHB with maternal antibodies and fetal cardiac anomalies.

    • Main Results:

    • 16 cases of isolated FCHB and 21 associated with structural heart disease were identified.
    • All isolated FCHB cases had maternal anti-Ro/SSA antibodies.
    • Fetuses with isolated FCHB had a significantly better survival rate (12/16 alive) compared to those with CHD (3/21 alive).

    Conclusions:

    • Isolated FCHB, strongly associated with maternal anti-Ro/SSA antibodies, has a better fetal outcome.
    • The presence of structural heart disease significantly reduces survival rates in fetuses with complete heart block.
    • Pacemaker implantation is a potential intervention for survivors of FCHB, regardless of associated cardiac malformations.