Document Detail


First-degree heart block in the fetus of an anti-SSA/Ro-positive mother: reversal after a short course of dexamethasone treatment.
MedLine Citation:
PMID:  15248221     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Samo Vesel; Uros Mazić; Tanja Blejec; Tomaz Podnar
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  50     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-12     Completed Date:  2004-08-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2223-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Cardiology, Unit, University Medical Center Ljubljana, Ljubljana, Slovenia. samo.vesel@mf.uni-lj.si
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies, Antinuclear / blood*
Dexamethasone / therapeutic use*
Echocardiography, Doppler, Pulsed
Female
Fetal Heart*
Glucocorticoids / therapeutic use*
Heart Block / drug therapy*,  ultrasonography
Humans
Pregnancy / blood,  immunology*
Treatment Outcome
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Glucocorticoids; 0/SS-A antibodies; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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