Iris Publishers-World Journal of Gynecology & Womens Health| Congenital Heart Block in Lupus Erythematosus Syndrome

Authored by Maria Caterina Corigliano

 

Congenital heart block is often associated with maternal anti Ro/SS-A and anti La/SSB antibodies that cross the placenta and damage the fetal AV node [1]. It occurs during the second trimester of gestation in asymptomatic women. In 2018 a 30-year-old, second gravida, was referred to the Department of Obstetrics, Ospedale San Giovanni Calibita, Fatebenefratelli, tertiary care Centre of Rome, for fetal AV block at 35 weeks of gestation.Autoimmune screening was performed and it revealed positivity to anti La/SS-A, anti-ANA, anti-RNP, anti-SM. She was not assuming corticosteroids. Previous ultrasounds revealed at the first trimester screening an increased Nuchal Translucency and in the second trimester a IIdegree AV block. Lupus erythematosus syndrome affects pregnancy with maternal and fetal/neonatal complications that could be screened and prevented by a close monitoring of pregnancy.Autoimmune screening with serum anti Ro/SS-A and anti La/ SSB antibodies should be performed to rule out the risk of fetal heart block. In patients with anti Ro/SS-A and anti La/SSB antibodies regular prenatal ultrasounds after the second trimester of pregnancy should be planned to detect: 1. Congenital heart block. Maternal steroids may be used in first- and second-degree heart block to prevent the progression in a complete heart block. Anyway, systematic prophylactic therapy is not recommended [2].

 

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