Korean J Obstet Gynecol.  2012 Jul;55(7):502-506. 10.5468/KJOG.2012.55.7.502.

Prevention of anti-SSA/Ro and anti-SSB/La antibodies-mediated congenital heart block in pregnant woman with systemic lupus erythematosus: A case report

• Lee JY
• Hur SE
• Lee SK

• KMID: 1992560
• DOI: http://doi.org/10.5468/KJOG.2012.55.7.502

Abstract

Women with connective tissue diseases increase risks of obstetric complications during pregnancy. Especially, women who have anti-SSA/Ro and anti-SSB/La auto-antibodies increase the risk of developing fetal atrioventricular (AV) block. It is difficult to indentify fetal AV block in the early stage of the disease, which is consequently found after the establishment of complete AV block as the form of fetal arrhythmia. To have a chance to reverse this serious disorder, we should detect fetal AV block in the early stage before it progresses to complete AV block. We experienced a case of pregnant systemic lupus erythematosus woman who has anti-SSA/Ro and anti-SSB/La auto-antibodies monitored by cardiac doppler sonography; We detected fetal first degree AV block and successfully treated with dexamethasone. We report systemic lupus erythematosus women who increased risks of fetal AV block with a brief review of relevant literatures.

Keyword

Systemic lupus erythematosus; Congenital heart block; Atrioventricular block; Anti-SSA/Ro and anti-SSB/La antibodies

MeSH Terms

Arrhythmias, Cardiac
Atrioventricular Block
Connective Tissue Diseases
Dexamethasone
Female
Heart
Heart Block
Humans
Lupus Erythematosus, Systemic
Pregnancy
Pregnant Women
Dexamethasone
Heart Block

Figure

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  Fig. 1 Pulsed Doppler flow curves showing normal atrioventricular relationship of cardiac rhythm. Doppler tracing from the superior vena cava (SVC) and ascending aorta. SVC flow has small atrial reversed wave (a). The aortic flow curve consists of a forward peak wave (s). Atrioventricular time interval is the time lapse between the onsets of vena caval a-wave and aortic s-wave (between grey lines).

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  Fig. 2 Pulsed Doppler was done at 26+1 weeks of gestation. Checked atrioventricular time intervals were 138 ms and 120 ms. These values were prolonged compared to normal range (reference range, 111±17 ms).

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  Fig. 3 Pulsed Doppler was done at 27+1 weeks of gestation. Checked atrioventricular time intervals were 114 ms and 108 ms. These values were within the normal range (reference range, 111±17 ms).

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