Fetal isolated congenital heart block associated with maternal anti-SSA/SSB antibodies

Vidyashri Kamath, Mahesh Navada, Dhara ., Prema D’Cunha

Abstract


Isolated Congenital Heart Block (CHB) affects 1:15000-20000 live births. 30-50% of fetuses with CHB will have a structural anomaly. Congenital heart block detected in utero is strongly associated with maternal antibodies to SSA (Ro) and SSB (La). Their pathogenic role in the development of CHB has been established in several studies. The mothers of affected infants frequently had autoimmune disease (systemic lupus erythematosus, Sjögren's syndrome) or were entirely asymptomatic.We report a case of fetal isolated congenital heart block in an asymptomatic mother with anti-SSA/SSB antibodies.


Keywords


Fetal congenital heart, Block, fetal bradycardia, Autoimmune antibodies

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References


Michaelsson M, Engle MA. Congenital complete heart block: an international study of the natural history. Cardiovasc Clin. 1972;4:85-101.

Gordon PA. Congenital heart block: clinical features and therapeutic approaches. Lupus. 2007;16:642-6.

Kannankeril PJ, Fish FA. Disorders of cardiac rhythm and conduction. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, eds. Moss and Adams’ Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult. 7th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2008: 293.

Buyon JP, Hiebert R, Copel J, Craft J, Friedman D, Katholi M et al. Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol. 1998;31(7):1658-66.

Costedoat-Chalumeau N, Georgin-Lavialle S, Amoura Z, Piette JC. Anti-SSA/Ro and anti-SSB/La antibody-mediated congenital heartblock. Lupus. 2005;14:660-4.

Groves AM, Allan LD, Rosenthal E. Outcome of isolated congenital complete heart block diagnosed in utero. Heart. 1996;75(2):190-4.

Groves AM, Allan LD, Rosenthal E. Therapeutic trial of sympathomimetics in three cases of complete heart block in the fetus. Circulation. 1995;92(12):3394-6.

Yang CH, Chen JY, Lee SC, Luo SF. Successful preventive treatment of congenital heart block during pregnancy in a woman with systemic lupus erythematous and anti-Sjögren's syndrome A/Ro antibody. J Microbiol Immunol Infect. 2005 Oct;38(5):365-9.

Jaeggi ET, Fouron JC, Silverman ED, Ryan G, Smallhorn J, Hornberger LK. Transplacental fetal treatment improves the outcome of prenatally diagnosed complete atrioventricular block without structural heart disease. Circulat. 2004;110:1542-8.

Schmidt KG, Ulmer HE, Silverman NH, Kleinman CS, Copel JA. Perinatal outcome of fetal complete atrioventricular block: a multicenter experience. J Am Coll Cardiol. 1991;17:1360-6.

Lopes LM, Tavares GM, Damiano AP, Lopes MA, Aiello VD, Schultz R et al. Perinatal outcome of fetalatrioventricular block: One-hundred-sixteen cases from a single institution. Circulat. 2008;118:1268-75.

Jaeggi ET, Hornberger LK, Smallhorn JF, Fouron JC. Prenatal diagnosis of complete atrioventricular block associated with structural heart disease: combined experience of two tertiary care centers and review of the literature. Ultrasound Obstet Gynaecol. 2005;26:16-21.

Berg C, Geipel A, Kohl T, Breuer J, Germer U, Krapp M et al. Atrioventricular block detected in fetal life: associated anomalies and potential prognostic markers. Ultrasound Obstet Gyanecol. 2005;26:4-15.