Discordant expression of maternal SLE in twin pregnancy with a single fetal AV block: A case report

There are multiple manifestations in the neonatal period for infants born to mothers with systematic lupus erythematosus (SLE), ranging from cardiac, hematologic and dermatologic abnormalities. Cardiac complications may arise in utero in the form of heart block with a resulting increase in fetal mortality. The fetal conduction system is suspected to be affected by transplacental maternal antibodies, however additional environmental and fetal factors appear to play a role. We describe a rare case of a dichorionic-diamniotic twin pregnancy in which only one twin developed a complete heart block progressing to hydrops fetalis and fetal demise.