title: Maternal antibody-associated fetal second-degree heart block and atrial flutter: case report and review.
abstract: Exposure to maternal anti-Ro (SS-A) and anti-La (SS-B) antibodies is a well-described risk factor for the development of fetal atrioventricular (AV) block. The role of maternal fluorinated steroids in the treatment and prevention of antibody-mediated fetal AV block is controversial. Fetal atrial flutter has rarely been described in association with maternal antibodies. This report describes a case of fetal exposure to maternal anti-Ro antibodies with associated second-degree AV block and atrial flutter. Interestingly, the reported patient had 2:1 AV conduction during both normal atrial rates (consistent with AV node conduction disease) and episodes of flutter (consistent with physiologic AV node functionality). The fetus was treated with transplacental digoxin and dexamethasone, which resolved both rhythm disturbances. The case report is followed by a brief discussion of AV block and atrial flutter associated with maternal antibody exposure.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, 30307, USA.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Sacks
authors.forename: Cyrus
authors.initials: C
authors.lastname: Samai
authors.forename: Kevin
authors.initials: K
authors.lastname: Gomez
authors.forename: Usama
authors.initials: U
authors.lastname: Kanaan
mesh_terms: D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology*; D001282:Atrial Flutter / Q000175:diagnosis / Q000196:embryology / Q000276:immunology*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000276:immunology*; D006327:Heart Block / Q000175:diagnosis / Q000196:embryology / Q000276:immunology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology*; D011297:Prenatal Exposure Delayed Effects / Q000276:immunology*; D016216:Ultrasonography, Prenatal
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies