title: Atrioventricular conduction delay in the second trimester measured by fetal magnetocardiography.
abstract: BACKGROUND
  Fetal AV block in SSA/Ro pregnancies is generally not seen before 18-week gestation and onset is rare after 28-week gestation. If complete AV block appears, it is believed to be irreversible. The purpose of the study was to evaluate precise electrophysiological AV conduction from 18-week gestation onwards.
  
  
  METHODS
  21 fetuses of pregnant women with collagen vascular diseases were included in the study group and 59 healthy fetuses served as controls. In addition to fetal echocardiography, fetal magnetocardiography (fMCG) was used to investigate precise electrophysiological fetal cardiac time intervals (fCTIs).
  
  
  RESULTS
  The PR segment (isoelectric segment between the end of the P wave and the start of the QRS complex) was significantly prolonged (P < 0.036 2nd trimester, P < 0.023 3rd trimester) in both trimesters within the study group. In fetuses less than 23-week gestational age, a nearly complete separation was found, where a PR segment of 60 ms or greater completely excluded control fetuses. All other fCTIs did not differ significantly. None of the fetuses progressed to a more advanced heart block.
  
  
  CONCLUSIONS
  Slight antibody effects in pregnancy, leading to PR segment prolongation, can already be seen from 18-week gestation onwards by fMCG. Serial fetal Doppler echocardiography and additional fMCG can be useful methods to measure early and precise AV conduction time, to achieve best surveillance for these high-risk pregnancies.
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, 72076 Tuebingen, Germany ; fMEG Center, University of Tuebingen, 72076 Tuebingen, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Wacker-Gussmann
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, 72076 Tuebingen, Germany.
authors.forename: Henrike
authors.initials: H
authors.lastname: Paulsen
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, 72076 Tuebingen, Germany ; fMEG Center, University of Tuebingen, 72076 Tuebingen, Germany.
authors.forename: Krunoslav
authors.initials: K
authors.lastname: Stingl
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital, 72076 Tuebingen, Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Braendle
authors.affiliation: Department of Neonatology, University Children's Hospital Tuebingen, 72076 Tuebingen, Germany.
authors.forename: Rangmar
authors.initials: R
authors.lastname: Goelz
authors.affiliation: Centre for Interdisciplinary Clinical Immunology, Rheumatology and Auto-Inflammatory Diseases and Department of Internal Medicine II (Oncology, Hematology, Immunology, Rheumatology, Pulmonology), University Hospital, 72076 Tuebingen, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Henes
mesh_terms: D000328:Adult; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography; D005260:Female; D005318:Fetal Heart / Q000503:physiopathology*; D005333:Fetus / Q000503:physiopathology*; D005865:Gestational Age; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D053798:Magnetocardiography; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D011262:Pregnancy Trimester, Second; D018566:Pregnancy, High-Risk; D012859:Sjogren's Syndrome / Q000503:physiopathology*
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