Congenital heart block with hydrops fetalis treated with high-dose dexamethasone; a case report.
A 32-year-old woman with systemic lupus erythematosus was found to have a fetus with heart block and fetal ascites at 23 weeks gestation. Treatment with high-dose corticosteroids ameliorated the early signs of heart failure, although the fetal heart rate gradually fell from 48 beats/min to 42 beats/min by 34 weeks. Sudden deterioration of the fetal state occurred at 35 weeks, and this only partially responded to digitalisation. Neonatal death occurred on Day 18 from the consequences of severe birth asphyxia. The relationship and pathogenesis of anti-Ro antibodies, congenital heart block and hydrops fetals are discussed, together with the in utero management of this condition.
Chua
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S
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Headington, Oxford, U.K.
Ostman-Smith
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Sellers
S
S
Redman
C W
CW
D000328:Adult; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D001324:Autoantigens / Q000276:immunology; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy*; D006327:Heart Block / Q000150:complications / Q000188:drug therapy / Q000196:embryology*; D006340:Heart Rate, Fetal; D006801:Humans; D015160:Hydrops Fetalis / Q000150:complications / Q000188:drug therapy / Q000196:embryology*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D011247:Pregnancy; D011248:Pregnancy Complications; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; D000099207:SS-A Antigen
D001323:Autoantibodies; D001324:Autoantigens; D003907:Dexamethasone; D020733:RNA, Small Cytoplasmic; D012261:Ribonucleoproteins; D000099207:SS-A Antigen; C116006:RO60 protein, human