Fetal Treatment of Congenital Heart Block Ascribed to Anti-SSA Antibody: Case Reports with Observation of Cardiohemodynamics and Review of the Literature
| Autor: | Yasuhiko Ebina, Emi H. Kato, Ritsu Yamamoto, Hideto Yamada, Masashi Moriwaki, Itsuko Furuta, Seiichiro Fujimoto |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
medicine.medical_specialty Heart block Prednisolone Pregnancy Complications Cardiovascular Immunology Autoantigens Dexamethasone Pregnancy Internal medicine Hydrops fetalis RNA Small Cytoplasmic Heart rate medicine Humans Immunology and Allergy Sinus rhythm Fetal Monitoring Glucocorticoids Fetus business.industry Infant Newborn Obstetrics and Gynecology Heart medicine.disease Fetal Diseases Preload Heart Block Sjogren's Syndrome Endocrinology Ribonucleoproteins Reproductive Medicine Echocardiography Antibodies Antinuclear Circulatory system Cardiology Female Electrical conduction system of the heart business |
| Zdroj: | American Journal of Reproductive Immunology. 42:226-232 |
| ISSN: | 1046-7408 |
| Popis: | Yamada H, Kato EH, Ebina Y, Moriwaki M, Yamamoto R, Furuta I and Fujimoto S. Fetal treatment of congenital heart block ascribed to anti-SSA antibody: case reports with observation of cardiohemodynamics and review of the literature. AJRI 1999; 42:226–232 © Munksgaard, Copenhagen PROBLEM: Maternal anti-SSA(B) antibody crosses the placenta and causes fetal myocarditis, congenital heart block (CHB), hydrops fetalis, and intrauterine fetal death. The aim of this study was to evaluate corticosteroids' efficacy as a treatment for CHB. METHOD OF STUDY: One fetus with complete CHB and one fetus with incomplete CHB due to anti-SSA(B) antibody received maternal prednisolone (PSL) and dexamethasone (DEXA) treatments. Heart rate, cardiothoracic ratio (CTR), left ventricular fractional shortening (FS), and preload index (PLI) were longitudinally measured by serial fetal echocardiograms. RESULTS: In the former case, after maternal PSL/DEXA administration, improvement of cardiohemodynamics, i. e., the reduction of PLI from 1.7 to 0.4, CTR from 70 to 52%, and FS from 63 to 54% were observed. In the latter case, second degree 2:1 block was converted to 3:2 block/sinus rhythm, resulting in the increase of the fetal heart rate from 65 to 116 beats per minute (bpm). CONCLUSIONS: We disclosed for the first time the beneficial effects of corticosteroids in the fetal cardiohemodynamics and conduction system of affected fetuses with the presence of maternal anti-SSA(B) antibodies. |
| Databáze: | OpenAIRE |
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