Variation in prenatal surveillance and management of anti-SSA/Ro autoantibody positive pregnancies

Figures & data

Figure 1. Geographical distribution of 59 unique respondent centers: 74.6% US centers, 8.5% Canadian, and 16.9% other international.

Table 1. Survey respondents’ training and practice center volumes.

	Respondents N = 101
Respondent Group Specialty
Pediatric or Fetal Cardiology	74	(73.3)
Maternal Fetal Medicine	27	(26.7)
Practice Type
Academic	80	(79.2)
Private Group Practice	11	(10.9)
Private Individual Practice	2	(2.0)
Other*	8	(7.9)
Years Practicing Since Completing Training
1–5 years	15	(14.9)
6–10 years	28	(27.7)
11–15 years	15	(14.9)
>15 years	42	(41.6)
No answer	1	(1.0)
Fetal echocardiograms performed per year (by all practitioners in the practice)
<500	23	(22.8)
500–1000	34	(33.7)
1000–1500	20	(19.8)
>1500	23	(22.8)
No answer	1	(1.0)
Anti-SSA/Ro autoantibody positive pregnancies referred to group per year
<5	13	(12.9)
5–10	32	(31.7)
11–20	30	(29.7)
>20	18	(17.8)
I don’t know	7	(6.9)
No answer	1	(1.0)

Format: n(%).

*Other Responses: Academic environment in a community hospital; Affiliated with academic center, but work out of another location than main campus; Community hospital based clinic practice; Hospital based; Hospital based; Private Health System; Regional outreach clinic.

Figure 2. Reported monitoring strategies for anti-SSA/Ro autoantibody pregnancies.

Figure 3. Distribution of the survey respondents recommended gestational ages to start and complete various monitoring strategies: A) fetal echocardiography, B) home handheld fetal heart rate monitoring, and C) in-office weekly or bi-weekly fetal heart rate monitoring.

Table 2. Variation in treatment of fetal atrioventricular block.

1°		2°		3°
Does your group treat AVB?
Yes	40 (40)	Yes	79 (78)	Yes	68 (67)
No	54 (54)	No	13 (13)	No	24 (24)
I don’t know	7 (7)	I don’t know	9 (9)	I don’t know	9 (9)
For what indications does your team treat ___ AVB? (select all that apply)
Prolonged AV interval without other abnormalities	34 (85)	Type 1 2° block without other abnormalities	55 (70)	3° block without other abnormalities	48 (71)
Prolonged AV interval with endocardial fibroelastosis	28 (70)	Type 1 2° block with endocardial fibroelastosis	59 (75)	3° block with endocardial fibroelastosis	55 (81)
Prolonged AV interval with mild-to-moderate tricuspid regurgitation	28 (70)	Type 1 2° block with mild-to-moderate tricuspid regurgitation	57 (71)	3° block with atrioventricular valve insufficiency	54 (79)
Prolonged AV interval with any degree of mitral regurgitation	27 (68)	Type 1 2° block with any degree of mitral regurgitation	56 (71)	3° block with ventricular dysfunction	56 (82)
Prolonged AV interval with pericardial effusion	26 (65)	Type 1 2° block with pericardial effusion	58 (73)	3° block co-occurring with other atrial or ventricular arrhythmias	50 (74)
I don’t know	0 (0)	Type 2 2° block without other abnormalities	61 (77)	3° block with pericardial effusion, hydrops, or other signs of fetal hemodynamic compromise	55 (81)
		Type 2 2° block with endocardial fibroelastosis	61 (77)	I don’t know	1 (1)
		Type 2 2° block with mild-to-moderate tricuspid regurgitation	60 (76)
		Type 2 2° block with any degree of mitral regurgitation	60 (76)
		Type 2 2° block with pericardial effusion	59 (75)
		I don’t know	5 (6)
What drugs does your group use to treat AVB?
Dexamethasone	31 (78)	Dexamethasone	41 (52)	Dexamethasone	28 (41)
IVIG	0 (0)	IVIG	0 (0)	IVIG	0 (0)
IVIG and Dexamethasone	9 (23)	IVIG and Dexamethasone	36 (46)	IVIG and Dexamethasone	36 (53)
Other	0 (0)	Other	0 (0)	Other (Dexamethasone and Terbutaline, Salbutamol)	2 (3)
I don’t know	0 (0)	I don’t know	2 (0)	I don’t know	2 (3)

Format: n (%).