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Review

Diagnosis and Management of Fetal Autoimmune Atrioventricular Block

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Pages 633-639 | Published online: 12 Aug 2020

References

  • The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin 106; Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009;114(1):192–202. doi:10.1097/AOG.0b013e3181aef106
  • Larmay HJ, Strasburger JF. Differential diagnosis and management of the fetus and newborn with an irregular or abnormal heart rate. Pediatr Clin North Am. 2004;51:1033–1050. doi:10.1016/j.pcl.2004.03.013
  • Michaelsson M, Engle MA. Congenital complete heart block: an international study of the natural history. Cardiovasc Clin. 1972;4(3):85–101.
  • Hunter LE, Simpson JM. Atrioventricular block during fetal life. J Saudi Heart Assoc. 2015;27:164–178. doi:10.1016/j.jsha.2014.07.001
  • Bordachar P, Whinnett Z, Ploux S, Labrousse L, Haissaguerre M, Thambo JB. Congenital complete atrioventricular block. Heart Rhythm. 2013;10:760–766. doi:10.1016/j.hrthm.2012.12.030
  • Salomonsson S, Sonesson SE, Ottosson L, et al. Ro/SSA Autoantibodies directly bind cardiomyocytes, disturb calcium homeostasis, and mediate congenital heart block. J Exp Med. 2005;201(1):11–17. doi:10.1084/jem.20041859
  • Sonesson SE, Salomonsson S, Jacobsson LA, Bremme K, Wahren-Herlenius M. Signs of first-degree heart block occur in one-third of fetuses of pregnant woman with anti-SSA/Ro 52-kd antibodies. Arthritis Rheum. 2004;50(4):1253–1261. doi:10.1002/art.20126
  • Spence D, Hornberger L, Hamilton R, Silverman ED. Increased risk of complete congenital heart block infants born to woman with hypothyroidism and anti-Ro and/or anti-La antibodies. J Rheumatol. 2006;33(1):167–170.
  • Rozenblyum EV, Sukhdeo S, Jeaggi E, et al. Anti-Ro and Anti-La antibodies in the general pregnant population [Abstract]. Arthritis Rheum. 2014;66(10 supplement):802.
  • Martínez-Sánchez N, Pérez-Pinto S, Robles-Marhuenda Á, et al. Obstetric and perinatal outcome in anti-Ro/SSA-positive pregnant woman: a prospective cohort study. Immunol Res. 2017;65:487–494. doi:10.1007/s12026-016-8888-5
  • Brucato A, Cimaz R, Caparali R, et al. Pregnancy outcome in patients with autoimmune diseases and Anti-Ro/SSA Antibodies. Clin Rev Allergy Immunol. 2011;40:27–41. doi:10.1007/s12016-009-8190-6
  • Carvalho JS. Fetal dysrhythmia. Best Pract Res Clin Obstet Gynaecol. 2008;22:31–38. doi:10.1016/j.bpobgyn.2008.01.001
  • Neild LE, Silverman ED, Smallhorn JF, et al. Endocardial fibroelastosis associated with maternal Anti-Lo and Anti-La antibodies in the absence of atrioventricular block. J Am Coll Cardiol. 2002;40:796–802. doi:10.1016/S0735-1097(02)02004-1
  • Buyon JP, Hiebert R, Copel J, et al. Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol. 1998;31:1658–1666. doi:10.1016/S0735-1097(98)00161-2
  • Donofrio MT, Moon-Grady- AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease; a scientific statement from the American Heart Association. Circulation. 2014;129:2183–2242. doi:10.1161/01.cir.0000437597.44550.5d
  • Wojakowski A, Izbizky G, Carcano ME, Aiello H, Marantz P, Otano L. Fetal Doppler mechanical PR interval: correlation with heart rate, gestational age and fetal sex. Ultrasound Obstet Gynecol. 2009;34:538–542. doi:10.1002/uog.7333
  • Glickstein JS, Buyon J, Friedman D. Pulsed Doppler echocardiographic assessment of the fetal PR interval. Am J Cardiol. 2000;86(2):236–239. doi:10.1016/S0002-9149(00)00867-5
  • Nii M, Hamilton RM, Fenwick L, Kingdom JCP, Roman KS, Jaeggi ET. Assessment of fetal atrioventricular time intervals by tissue Doppler and pulse Doppler echocardiography: normal values and correlation with fetal electrocardiography. Heart. 2006;92(12):1831–1837. doi:10.1136/hrt.2006.093070
  • DeVore GR, Horenstein J. Simultaneous Doppler recording of the pulmonary artery and vein: a new technique for the evaluation of a fetal arrhythmia. J Ultrasound Med. 1993;12:669–671. doi:10.7863/jum.1993.12.11.669
  • Jeaggi ET, Nii M. Fetal brady- and tachyarrhythmias: new and accepted diagnostic and treatment methods. Semin Fetal Neonatal Med. 2005;10:504–514. doi:10.1016/j.siny.2005.08.003
  • Friedman DM, Kim MY, Copel JA, et al. Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR interval and dexamethasone evaluation (PRIDE) prospective study. Circulation. 2008;117:485–493. doi:10.1161/CIRCULATIONAHA.107.707661
  • Mevorach D, Elchalal U, Rein AJ. Prevention of complete heart block in children of mothers with anti-SSA/Ro and anti-SSB/La autoantibodies: detection and treatment of first-degree atrioventricular block. Curr Opin Rheumatol. 2009;21:478–482. doi:10.1097/BOR.0b013e32832ed817
  • Rein AJJT, O’Donnell C, Geva T, et al. Use of tissue velocity imaging in the diagnosis of fetal cardiac arrhythmias. Circulation. 2002;106:1827–1833. doi:10.1161/01.CIR.0000031571.92807.CC
  • Cuneo BF, Ambrose SE, Tworetzky W. Detection and successful treatment of emergent anti-SSA-mediated fetal atrioventricular block. Am J Obstet Gynecol. 2016;215(4):527–528. doi:10.1016/j.ajog.2016.07.002
  • Sonesson SE, Ambrosi A, Wahren-Herlenius M. Benefits of fetal echocardiographic surveillance in pregnancies at risk of congenital heart block: single-center study of 212 anti-Ro52-positive pregnancies. Ultrasound Obstet Gynecol. 2019;54:87–95. doi:10.1002/uog.20214
  • Cuneo BF, Moon-Grady AJ, Sonesson SE, et al. Heart sounds at home: feasibility of an ambulatory fetal heart rhythm surveillance program for anti-SSA-positive pregnancies. J Perinatol. 2017;37:226–230. doi:10.1038/jp.2016.220
  • Jaeggi E, Laskin C, Hamilton R, Kingdom J, Silverman E. The importance of the level of maternal anti-Ro/SSA antibodies as a prognostic marker of the development of cardiac neonatal lupus erythematosus: a prospective study of 186 antibody-exposed fetuses and infants. J Am Coll Cardiol. 2010;55:2778–2784. doi:10.1016/j.jacc.2010.02.042
  • Kan N, Silverman ED, Kingdom J, Dutil N, Laskin C, Jeaggi E. Serial echocardiography for immune-mediated heart disease in the fetus: results of a risk-based prospective surveillance strategy. Prenat Diagn. 2017;37:375–382. doi:10.1002/pd.5021
  • Tunks RD, Clowse MEB, Miller SG, Brancazio LR, Barker PCA. Maternal autoantibody levels in congenital heart block and potential prophylaxis with anti-inflammatory agents. Am J Obstet Gynecol. 2013;208(1):64.e1–e7. doi:10.1016/j.ajog.2012.09.020
  • Izmirly PM, Costedoat-Chalumeau N, Pisoni CN, et al. Maternal use of hydroxychloroquine is associated with a reduced risk of recurrent anti-SSA/Ro-antibody-associated cardiac manifestations of neonatal lupus. Circulation. 2012;126:76–82. doi:10.1161/CIRCULATIONAHA.111.089268
  • Andreoli L, Bertsias GK, Agmon-Levin N, et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017;76:476–485. doi:10.1136/annrheumdis-2016-209770
  • Jaeggi ET, Silverman ED, Laskin C, Kingdom J, Golding F, Weber R. Prolongation of the atrioventricular conduction in fetuses exposed to maternal anti-Ro/SSA and anti-La/SSB antibodies did not predict progressive heart block. A prospective observational study on the effects of maternal antibodies on 165 fetuses. J Am Coll Cardiol. 2011;57:1487–1492. doi:10.1016/j.jacc.2010.12.014
  • Saleeb S, Copel J, Friedman D, Buyon JP. Comparison of treatment with fluorinated glucocorticoids to the natural history of autoantibody-associated congenital heart block. Arthritis Rheum. 1999;42:2335–2345. doi:10.1002/1529-0131(199911)42:11<2335::AID-ANR12>3.0.CO;2-3
  • Ciardulli A, D’Antonio F, Magro-Malosso ER, et al. Maternal steroid therapy for fetuses with second-degree immune-mediated congenital atrioventricular block: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2018;97:787–794. doi:10.1111/aogs.13338
  • Michael A, Radwan AA, Ali AK, et al. Use of antenatal fluorinated corticosteroids in management of congenital heart block: systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X. 2019;16(4):100072. doi:10.1016/j.eurox.2019.100072
  • Eliasson H, Sonesson S, Sharland G, et al. Isolated atrioventricular block in the fetus: a retrospective, multinational, multicenter study of 175 patients. Circulation. 2011;124(18):1919–1926. doi:10.1161/CIRCULATIONAHA.111.041970
  • Hutter D, Silverman ED, Jaeggi ET. The benefits of transplacental treatment of isolated congenital complete heart block associated with maternal anti-Ro/SSA antibodies: a review. Scand J Immunol. 2010;72:235–241. doi:10.1111/j.1365-3083.2010.02440.x
  • Wapner RJ, Sorokin Y, Mele L, et al. Long-term outcomes after repeat doses of antenatal corticosteroids. N Eng J Med. 2007;357:1190–1198. doi:10.1056/NEJMoa071453
  • Jaeggi ET, Fouron JC, Silverman ED, Ryan G, Smallhorn J, Hornberger LK. Transplacental fetal treatment improves the outcome of prenatally diagnosed complete atrioventricular block without structural heart disease. Circulation. 2004;110:1542–1548. doi:10.1161/01.CIR.0000142046.58632.3A
  • Yoshida H, Iwamoto M, Sakakibara H, Shigeta H, Hirahara F, Sata K. Treatment of fetal congenital complete heart block with maternal administration of beta-sympathomimetics (terbutaline). Gynecol Obstet Invest. 2001;52:142–144. doi:10.1159/000052960
  • Matsushita H, Higashino M, Sekizuka N, Kurabayashi T, Takakuwa K, Tanaka K. Successful prenatal treatment if congenital heart block with ritodrine administered transplacentally. Arch Gynecol Obstet. 2002;267:51–53. doi:10.1007/s004040100241
  • Groves AMM, Allan LD, Rosenthal E. Therapeutic trial of sympathomimetics in three cases of complete heart block in the fetus. Circulation. 1995;92:3394–3396. doi:10.1161/01.CIR.92.12.3394
  • Chan AY, Silverman RK, Smith FC, Geifman-Holtzman O. In utero treatment of fetal complete heart block with terbutaline. A case report. J Reprod Med. 1999;44(4):385–387.
  • Robinson BV, Ettedgui JA, Sherman FS. Use of terbutaline in the treatment of complete heart block in the fetus. Cardiol Young. 2001;11(6):683–686. doi:10.1017/S1047951101001123
  • David AL, Ataullah I, Yates R, Sullivan I, Charles P, William D. Congenital fetal heart block. A potential therapeutic role for intravenous immunoglobulin. Obstet Gynecol. 2010;116:543–547. doi:10.1097/AOG.0b013e3181e75a4a
  • Friedman DM, Llanos C, Izmirly P, et al. Evaluation of fetuses in a study of intravenous immunoglobulin as preventive therapy for congenital heart block. Arthritis Rheum. 2010;62:1138–1146. doi:10.1002/art.27308
  • Ruffatti A, Milanesi O, Chiandetti L, et al. A combination therapy to treat second-degree anti-Ro/La-related congenital heart block. A strategy to avoid stable third-degree heart block? Lupus. 2012;21:666–671.
  • Ruffatti A, Cerutti A, Favaro M, et al. Plasmapheresis, intravenous immunoglobulins and bethametasone – a combined protocol to treat autoimmune congenital heart block: a prospective cohort study. Clin Exp Rheumatol. 2016;34(4):706–713.
  • Trucco SM, Jaeggi E, Cuneo B, et al. Use of intravenous gamma globulin and corticosteroids in the treatment of maternal autoantibody-mediated cardiomyopathy. J Am Coll Cardiol. 2011;57:715–723. doi:10.1016/j.jacc.2010.09.044
  • Assad RS, Zielinsky P, Kalil R, et al. New electrode for pacing fetuses with complete heart block. Rev Bras Cir Cardiovasc. 2003;18(1):40–44. doi:10.1590/S0102-76382003000100009
  • Walkinshaw SA, Welch CR, McCormack J, Walsh K. In utero pacing for fetal congenital heart block. Fetal Diagn Ther. 1994;9:183–185. doi:10.1159/000263929
  • Schmidt KG, Ulmer HE, Silverman NH, Kleinman CS, Copel JA. Perinatal outcome of fetal complete atrioventricular block: a multicenter experience. J Am Coll Cardiol. 1991;17:1360–1366. doi:10.1016/S0735-1097(10)80148-2
  • Waltuck J, Buyon J. Autoantibody-associated congenital heart block: outcome in mothers and children. Ann Intern Med. 1994;120:544–551. doi:10.7326/0003-4819-120-7-199404010-00003
  • Kuleva M, Le Bidois J, Decaudin A, et al. Clinical course and outcome of antenatally detected atrioventricular block: experience of a single tertiary centre and review of the literature. Prenat Diagn. 2015;35:354–361. doi:10.1002/pd.4547