title: Clinical course and outcome of antenatally detected atrioventricular block: experience of a single tertiary centre and review of the literature.
abstract: OBJECTIVE
  The objective is to study the course and outcome of fetuses with congenital atrioventricular block (AVB) in a single centre.
  
  
  METHODS
  Retrospective analysis of cases diagnosed prenatally with second and third degree AVB. The clinical characteristics and outcome of fetal AVB were evaluated including in utero treatment.
  
  
  RESULTS
  Sixty-two cases were studied. AVB was associated with a congenital heart defect (CHD-AVB) in 17 cases (27%), whereas it was isolated (i-AVB) in 45 (73%), 42 of which were associated with maternal antibodies. There were nine (52.9%) live births in the CHD-AVB group, five of which (55%) resulted in infant deaths. In the i-AVB group, there were 40/45 (88.9%) live births and 1/40 (2.5%) infant death; 36 (90%) babies required a permanent pacemaker. The only factor predictive of postnatal death was the presence of CHD (5/9 vs 1/39 or 48.7 [3.6; 1457.7], p < 0.001). Nineteen fetuses (40.5%) with i-AVB received steroids in utero. No difference in outcome was found between the AVB treated in utero versus the no-treatment group in terms of permanent pacemaker placement, postnatal death or development of dilated cardiomyopathy.
  
  
  CONCLUSIONS
  The most important prognostic factor for congenital AVB is the association with CHD. In utero treatment remains questionable.
authors.affiliation: Department of Obstetrics and Gynecology, M3C-Necker, Hôpital Necker Enfants malades, 75015, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Kuleva
authors.forename: J
authors.initials: J
authors.lastname: Le Bidois
authors.forename: A
authors.initials: A
authors.lastname: Decaudin
authors.forename: E
authors.initials: E
authors.lastname: Villain
authors.forename: N
authors.initials: N
authors.lastname: Costedoat-Chalumeau
authors.forename: D
authors.initials: D
authors.lastname: Lemercier
authors.forename: Y
authors.initials: Y
authors.lastname: Dumez
authors.forename: Y
authors.initials: Y
authors.lastname: Ville
authors.forename: D
authors.initials: D
authors.lastname: Bonnet
authors.forename: L J
authors.initials: LJ
authors.lastname: Salomon
mesh_terms: D000328:Adult; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000188:drug therapy; D002675:Child, Preschool; D005260:Female; D005333:Fetus; D005938:Glucocorticoids / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids