Congenital heart block in successive pregnancies: a case report and evaluation of risk with therapeutic consideration.
SS-A antibody has been found to bind to fetal cardiac tissue and is thought to mediate congenital heart block via transplacental passage. Recent papers have identified various risk factors thought to define subclasses of SS-A antibody-positive mothers at greater risk of delivering children with congenital heart block. Treatment modalities for antibody-mediated fetal insult are now expanding and being used clinically. We report a case of a clinically asymptomatic SS-A antibody-producing mother who gave birth to two SS-A antibody-positive children with congenital heart block. It is our hope that ongoing refinement of risk factors and effective therapy will result in successful in utero palliation of the effects of SS-A antibody.
Department of Internal Medicine, Ochsner Clinic, New Orleans, Louisiana.
J S
JS
Scheib
J
J
Waxman
D000328:Adult; D000974:Antibodies, Antinuclear / Q000032:analysis*; D004374:Ductus Arteriosus, Patent / Q000209:etiology; D005260:Female; D006327:Heart Block / Q000151:congenital*; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007231:Infant, Newborn; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012307:Risk Factors
D000974:Antibodies, Antinuclear; C035356:SS-A antibodies