First-degree heart block in the fetus of an anti-SSA/Ro–positive mother: Reversal after a short course of dexamethasone treatment
✍ Scribed by Samo Vesel; Uroš Mazić; Tanja Blejec; Tomaž Podnar
- Publisher
- John Wiley and Sons
- Year
- 2004
- Tongue
- English
- Weight
- 96 KB
- Volume
- 50
- Category
- Article
- ISSN
- 0004-3591
No coin nor oath required. For personal study only.
✦ Synopsis
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.