[Auriculo-ventricular block and pregnancy]

20 cases of pregnancy in women with complete atrioventricular block (AVB) (12 patients) or with permanent pacemakers (8 patients) were observed in a French cooperative series and compared with I30 previously reported cases. Most patients were asymptomatic but an increase in the number of syncopes during gestation might be observed : 4 out of 12 in our series. Although AVB remains functionally latent during pregnancy, regular cardio-obstetric follow-up is advised. Hospital admission a few days before the expected date of delivery is desirable, and it is essential that the patients are delivered in department specialised in high risk pregnancies. The need for prophylactic temporary pacing during delivery is not universally accepted. On the other hand, dizziness and syncope are clear cut indications for permanent cardiac pacing ; programmable pacers are excellent choices in young women of childbearing age ; nuclear pulse generators (Pu 238) do not seem to expose the mothers or foetus to serious complications. Rejection of pulse generators during pregnancy is rare. Nearly all mothers with AVB, whether paced or not, now have normal pregnancies resulting in normal viable children. This conduction defect is not therefore an indication for therapeutic abortion.