title: Correlation of Maternal Autoantibodies with Fetal Congenital Heart Block.
abstract: BACKGROUND
  Autoimmune fetal congenital heart block (CHB) is the most severe manifestation of neonatal lupus, and it is seen when maternal autoimmune antibodies cross the placenta and damage the AV node of the fetus. CHB is mainly associated with maternal SLE with anti-Ro/SSA- and anti-La/SSB-positive status, and incidence of CHB increases when both the antibodies are present. This study was conducted to know the incidence of fetal CHB in patients of SLE who had ANA, anti-Ro/SSA and anti-La/SSB positivity.
  
  
  METHODS
  A prospective study was conducted in a tertiary-care teaching hospital of Indian Armed Forces between Jan 2012 to Sep 2014 where 13 cases of SLE were studied. All these patients were tested for ANA, anti-Ro/SSA and anti-La/SSB antibodies and fetal heart abnormalities. Fetuses with CHB were treated with steroids.
  
  
  RESULTS
  Incidence of SLE was 0.14 %, 92 % of SLE patients were positive for ANA, and 46 % had anti-Ro/SSA- and anti-La/SSB-positive status. Two fetuses had congenital heart block, and one fetus required pacemaker placement 5 months after delivery.
  
  
  CONCLUSIONS
  All the fetal congenital heart blocks are associated with maternal anti-Ro/SSA and anti-La/SSB and ANA antibodies. Treatment by steroids may improve the outcome in early stages of fetal CHB, and delivery with follow-up should be planned in a tertiary-care center where pacemaker placement facility is available.
authors.affiliation: Department of Obstetrics and Gynecology, Armed Forces Medical College, Pune, 411040 India.
authors.forename: Dey
authors.initials: D
authors.lastname: Madhusudan
authors.affiliation: Department of Obstetrics and Gynecology, Armed Forces Medical College, Pune, 411040 India.
authors.forename: Agarwal
authors.initials: A
authors.lastname: Raju
authors.affiliation: Department of Obstetrics and Gynecology, Armed Forces Medical College, Pune, 411040 India.
authors.forename: Nambula
authors.initials: N
authors.lastname: Vijaya
keywords: Autoantibodies; Fetal congenital heart block; Pacemaker; Steroid; Systemic lupus erythematosus