Fetal Treatment of Congenital Heart Block Ascribed to Anti-SSA Antibody: Case Reports with Observation of Cardiohemodynamics and Review of the Literature
Article first published online: 6 SEP 2011
American Journal of Reproductive Immunology
Volume 42, Issue 4, pages 226–232, October 1999
How to Cite
Yamada, H., Kato, E. H., Ebina, Y., Moriwaki, M., Yamamoto, R., Furuta, I. and Fujimoto, S. (1999), Fetal Treatment of Congenital Heart Block Ascribed to Anti-SSA Antibody: Case Reports with Observation of Cardiohemodynamics and Review of the Literature. American Journal of Reproductive Immunology, 42: 226–232. doi: 10.1111/j.1600-0897.1999.tb00095.x
- Issue published online: 6 SEP 2011
- Article first published online: 6 SEP 2011
- revised January 4, 1999; accepted January 7, 1999.
- Anti-SS-A(B) antibody;
- A-V block;
- hydrops fetalis;
- systemic lupus erythematosus
Yamada H, Kato EH, Ebina Y, Moriwaki M, Yamamoto R, Furuta I and Fujimoto S. Fetal treatment of congenital heart block ascribed to anti-SSA antibody: case reports with observation of cardiohemodynamics and review of the literature. AJRI 1999; 42:226–232 © Munksgaard, Copenhagen
PROBLEM: Maternal anti-SSA(B) antibody crosses the placenta and causes fetal myocarditis, congenital heart block (CHB), hydrops fetalis, and intrauterine fetal death. The aim of this study was to evaluate corticosteroids' efficacy as a treatment for CHB.
METHOD OF STUDY: One fetus with complete CHB and one fetus with incomplete CHB due to anti-SSA(B) antibody received maternal prednisolone (PSL) and dexamethasone (DEXA) treatments. Heart rate, cardiothoracic ratio (CTR), left ventricular fractional shortening (FS), and preload index (PLI) were longitudinally measured by serial fetal echocardiograms.
RESULTS: In the former case, after maternal PSL/DEXA administration, improvement of cardiohemodynamics, i. e., the reduction of PLI from 1.7 to 0.4, CTR from 70 to 52%, and FS from 63 to 54% were observed. In the latter case, second degree 2:1 block was converted to 3:2 block/sinus rhythm, resulting in the increase of the fetal heart rate from 65 to 116 beats per minute (bpm).
CONCLUSIONS: We disclosed for the first time the beneficial effects of corticosteroids in the fetal cardiohemodynamics and conduction system of affected fetuses with the presence of maternal anti-SSA(B) antibodies.