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Correlation of Maternal Autoantibodies with Fetal Congenital Heart Block

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Abstract

Background

Autoimmune fetal congenital heart block (CHB) is the most severe manifestation of neonatal lupus, and it is seen when maternal autoimmune antibodies cross the placenta and damage the AV node of the fetus. CHB is mainly associated with maternal SLE with anti-Ro/SSA- and anti-La/SSB-positive status, and incidence of CHB increases when both the antibodies are present. This study was conducted to know the incidence of fetal CHB in patients of SLE who had ANA, anti-Ro/SSA and anti-La/SSB positivity.

Methods

A prospective study was conducted in a tertiary-care teaching hospital of Indian Armed Forces between Jan 2012 to Sep 2014 where 13 cases of SLE were studied. All these patients were tested for ANA, anti-Ro/SSA and anti-La/SSB antibodies and fetal heart abnormalities. Fetuses with CHB were treated with steroids.

Results

Incidence of SLE was 0.14 %, 92 % of SLE patients were positive for ANA, and 46 % had anti-Ro/SSA- and anti-La/SSB-positive status. Two fetuses had congenital heart block, and one fetus required pacemaker placement 5 months after delivery.

Conclusion

All the fetal congenital heart blocks are associated with maternal anti-Ro/SSA and anti-La/SSB and ANA antibodies. Treatment by steroids may improve the outcome in early stages of fetal CHB, and delivery with follow-up should be planned in a tertiary-care center where pacemaker placement facility is available.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Armed Forces Medical College, Pune, 411040, India

    Dey Madhusudan, Agarwal Raju & Nambula Vijaya

Authors
  1. Dey Madhusudan
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  2. Agarwal Raju
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  3. Nambula Vijaya
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Corresponding author

Correspondence to Dey Madhusudan.

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Conflict of interest

Dey Madhusudan, Agarwal Raju and Nambula Vijaya declare that they have no conflict of interest.

Informed Consent

Additional informed consent was obtained from all patients for whom identifying information is included in this article.

Additional information

Dr. Dey Madhusudan MS and Agarwal Raju MD are Reader; Nambula Vijaya MBBS is a Resident at Department of Obstetrics and Gynecology, Armed Forces Medical College, Pune 411040, India.

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Madhusudan, D., Raju, A. & Vijaya, N. Correlation of Maternal Autoantibodies with Fetal Congenital Heart Block. J Obstet Gynecol India 66 (Suppl 1), 112–116 (2016). https://doi.org/10.1007/s13224-015-0813-7

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  • DOI: https://doi.org/10.1007/s13224-015-0813-7

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