[Problem of fetal arrhythmias--a case report]

A fetal congenital complete AV-block was detected in the 30th week of gestation. After close sonographic and cardiotocographic follow-up examinations premature labor occurred in the 37th week of gestation. The interpretation of the fetal heart rate pattern was difficult. The bradycardia was accompanied by late decelerations (dip II), only different from familiar hypoxia-patterns by the bradycardia. Caesarean section therefore was immediately done. A partial abruptio placentae was found as causing hypoxia. The child developed well after insertion of a temporary transvenous pacemaker. The AV-block is still persisting. At the age of three months the child fell ill of an acute cutaneous lupus erythematosus. The symptoms disappeared after unspecific treatment. Antinuclear antibodies pathognomonic for lupus erythematosus were traceable in the symptomless mother. There are other observations of motherly autoantibodies passing the placental barrier impairing the fetal heart conduction.