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Outcomes of fetal echocardiographic surveillance in anti-SSA exposed fetuses at a large fetal cardiology center.
MedLine Citation:
PMID:  24989941     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Echocardiography screening in anti-SSA antibody exposed fetuses is controversial.
OBJECTIVE: Evaluate utility of fetal echocardiography in anti-SSA exposure.
METHODS: Echocardiograms done over 9 years for maternal anti-SSA exposure were reviewed for AV block, cardiomyopathy, arrhythmias, effusion, valve abnormalities, or other abnormalities identified by the echocardiographer. Fetuses with AV block referred to our institution and subsequently found to be anti-SSA exposed were also identified.
RESULTS: Six hundred thirty six echocardiograms were performed on 140 fetuses (Cohort 1) of 134 women screened for maternal anti-SSA +/- anti-SSB antibodies. No fetuses developed second or third degree AV block or cardiomyopathy (odds ratio 0.1, CI 0.0051 to 1.9410, p=0.13). Dexamethasone was administered to three fetuses for sinus bradycardia, echogenicity near AV node, and ventricular systolic dysfunction with valve regurgitation; all normalized. Screening echocardiograms identified: sinus bradycardia (n=1), PR prolongation (n=5), premature atrial contractions (n=3), valve regurgitation (n=24), echogenic myocardium (n=4), and pericardial effusion (n=1). Isolated tricuspid regurgitation and first degree AV block did not progress. Nine cases of SSA-mediated AV block (Cohort 2) were referred after heart block developed.
CONCLUSIONS: Serial fetal echocardiography in anti-SSA exposed fetuses did not detect AV block. In rare cases, dexamethasone treatment may have affected disease course. This article is protected by copyright. All rights reserved.
Authors:
Anita Krishnan; Bhawna Arya; Jeffrey P Moak; Mary T Donofrio
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-3
Journal Detail:
Title:  Prenatal diagnosis     Volume:  -     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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