Congenital Complete Heart Block

Published on 07/06/2015 by admin

Filed under Neonatal - Perinatal Medicine

Last modified 07/06/2015

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23 Congenital Complete Heart Block

I. CASE

A 35-year-old white woman, gravida 4, para 2, was referred at 22 weeks’ gestation by the obstetrician for fetal bradycardia. The mother has systemic lupus erythematosus (SLE) with a high titer of anti-Ro (SSA) antibodies. Her cardiac evaluation showed unifocal premature ventricular contractions (PVCs) but no evidence of myocardial dysfunction or pericarditis.

A. Fetal echocardiography findings

D. Fetal management and counseling

1. Amniocentesis is not offered because the risk from amniocentesis is higher than the risk of abnormal karyotype in isolated CCHB.

2. Fetal management of CHB.

a. Fetal drug therapy has been mainly directed toward three different features of the disease entity.

b. Premature delivery.

c. Fetal ventricular pacing.

3. Follow-up included serial antenatal studies at 1- to 2-week intervals.

a. Mother’s follow-up.

b. Fetus’s follow-up: A fetal ECG and general fetal surveillance should be provided every 1 to 2 weeks. The following should be serially evaluated: