title: Outcomes of fetal echocardiographic surveillance in anti-SSA exposed fetuses at a large fetal cardiology center.
abstract: BACKGROUND
  Echocardiography screening in anti-SSA antibody exposed fetuses is controversial.
  
  
  OBJECTIVE
  The aim of this study is to evaluate utility of fetal echocardiography in anti-SSA exposure.
  
  
  METHODS
  Echocardiograms performed over 9 years for maternal anti-SSA exposure were reviewed for atrioventricular (AV) block, cardiomyopathy, arrhythmias, effusion, valve abnormalities, or other abnormalities identified by the echocardiographer. Fetuses with AV block referred to our institution and subsequently found to be anti-SSA exposed were also identified.
  
  
  RESULTS
  Six hundred thirty six echocardiograms were performed on 140 fetuses (Cohort 1) of 134 women screened for maternal anti-SSA +/- anti-SSB antibodies. No fetuses developed second or third-degree AV block or cardiomyopathy (odds ratio 0.1, CI 0.0051 to 1.9410, p = 0.13). Dexamethasone was administered to three fetuses for sinus bradycardia, echogenicity near AV node, and ventricular systolic dysfunction with valve regurgitation; all normalized. Screening echocardiograms identified: sinus bradycardia (n = 1), PR prolongation (n = 5), premature atrial contractions (n = 3), valve regurgitation (n = 24), echogenic myocardium (n = 4), and pericardial effusion (n = 1). Isolated tricuspid regurgitation and first-degree AV block did not progress. Nine cases of SSA-mediated AV block (Cohort 2) were referred after heart block developed.
  
  
  CONCLUSIONS
  Serial fetal echocardiography in anti-SSA exposed fetuses did not detect AV block. In rare cases, dexamethasone treatment may have affected disease course.
authors.affiliation: Department of Cardiology, Children's National Heart Institute, Children's National Medical Center, 111 Michigan Ave, NW, Washington, DC, 20010, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Krishnan
authors.forename: Bhawna
authors.initials: B
authors.lastname: Arya
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Moak
authors.forename: Mary T
authors.initials: MT
authors.lastname: Donofrio
mesh_terms: D054537:Atrioventricular Block / Q000000981:diagnostic imaging* / Q000276:immunology; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000276:immunology; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000276:immunology; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000276:immunology; D006801:Humans; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000276:immunology; D011247:Pregnancy; D012189:Retrospective Studies; D012261:Ribonucleoproteins; D000099207:SS-A Antigen
chemical_list: D012261:Ribonucleoproteins; D000099207:SS-A Antigen