First-degree heart block in the fetus of an anti-SSA/Ro-positive mother: reversal after a short course of dexamethasone treatment

Arthritis and Rheumatism
Samo VeselTomaz Podnar

Abstract

Isolated congenital heart block is almost invariably associated with the presence of antibodies to SSA/Ro and SSB/La antigens in the maternal circulation. Once established, third-degree congenital heart block is permanent. However, a lesser degree of autoantibody-associated heart block in a fetus can be reversed if it is recognized and treated early enough with fluorinated glucocorticosteroids. The only method available clinically for the recognition of first-degree heart block in a fetus is measurement of the mechanical PR interval by pulsed Doppler echocardiography. This is the first report of a fetus in whom a diagnosis of first-degree heart block and the consequent decision to intervene were based solely on this technique. In addition, the first-degree heart block resolved completely after only 2 weeks of dexamethasone treatment, and the heart rhythm remained stable throughout the remainder of the pregnancy despite early discontinuation of therapy due to oligohydramnios.

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Citations

Feb 15, 2005·Prenatal Diagnosis
May 23, 2006·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·J M Simpson
Aug 11, 2010·Scandinavian Journal of Immunology·S-E Sonesson
Nov 1, 2005·Seminars in Fetal & Neonatal Medicine·Greggory R DeVore
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Mar 17, 2007·Journal of Perinatology : Official Journal of the California Perinatal Association·M MottaG Chirico
May 18, 2021·Frontiers in Cardiovascular Medicine·Hongyu LiaoYifei Li

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