Persistent fetal sinus bradycardia associated with maternal anti-SSA/Ro and anti-SSB/La antibodies.

Chockalingam, Priya; Jaeggi, Edgar T; Rammeloo, Lukas A; Haak, Monique C; Adama van Scheltema, Phebe N; Breur, Johannes M P J; Bartelings, Margot M; Clur, Sally-Ann B et al. · J Rheumatol · 2011

case_report · Level V

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Abstract

To study the clinical course and outcome of fetal sinus bradycardia (SB) due to maternal antibody-induced sinus node dysfunction. We reviewed the maternal, prenatal, and postnatal findings of fetuses with SB associated with elevated maternal anti-SSA/Ro and anti-SSB/La antibodies. Of the 6 cases diagnosed prenatally, 3 had isolated SB persisting after birth and had a good prognosis. Three fetuses with SB and severe myocardial involvement (congenital complete heart block and/or endocardial fibroelastosis) succumbed in utero in spite of treatment. Postmortem histopathology in 1 fetus showed inflammatory destruction of the sinus and atrioventricular nodes. SB was detected incidentally in a 7-year-old girl. She had intermittent heart block with progressive sinus arrest requiring permanent pacemaker. Fetal SB associated with maternal autoantibodies may persist in childhood, with a good prognosis in the absence of widespread cardiac involvement.

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