Congenital Complete Heart Block Requiring Temporary Pacemaker Placement at Birth: A Case Report

Area of Science:

• Cardiology
• Immunology
• Maternal-Fetal Medicine

Background:

• Congenital heart block (CHB) is a rare condition affecting fetal cardiac conduction.
• Neonatal lupus antibodies, particularly SSA antibodies, are a common cause of CHB, leading to AV node destruction.
• Congenital complete heart block (CCHB) is the most frequent manifestation.

Purpose of the Study:

• To report a case of fetal bradycardia diagnosed as third-degree heart block.
• To emphasize the critical role of multidisciplinary coordination in managing fetal and neonatal CCHB.
• To discuss the etiology, diagnosis, and management of fetal cardiac abnormalities and CCHB.

Main Methods:

• Fetal ultrasound and echocardiography for diagnosis of bradycardia and heart block.
• Maternal serological testing for SSA antibodies.
• Multidisciplinary team approach for antepartum, delivery, and neonatal care.

Main Results:

• A 23-year-old mother's fetus was diagnosed with third-degree heart block at 21 weeks gestation.
• Maternal testing revealed positive SSA antibodies.
• Successful management involved coordinated care from pregnancy through neonatal cardiovascular support.

Conclusions:

• Early diagnosis of fetal bradycardia and CCHB is crucial.
• Maternal SSA antibodies are a significant risk factor for CCHB.
• Multidisciplinary planning and preparation are essential for optimizing outcomes in high-risk fetal cardiac interventions and neonatal care.