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Favorable Outcome in a Pregnancy With Complete Fetal Heart Block and Severe Bradycardia

Minassian, Vatche A. MD; Jazayeri, Allahyar MD, PhD

Obstetrics & Gynecology:
Case Reports
Abstract

BACKGROUND: Pregnancies complicated by congenital heart block usually have a poor prognosis when there is severe fetal bradycardia.

CASE: We present a pregnancy with fetal heart rate of 40 beats per minute. She previously delivered a child with third-degree heart block by cesarean at 28 weeks. This pregnancy was complicated by a high ribonucleoprotein antibody anti-Ro/SSA titer and fetal bradycardia. The patient was treated with steroids and β-mimetics. The fetus continued to grow normally with reassuring biophysical profiles. After fetal lung maturity documentation at 34 weeks, she delivered by repeat cesarean a healthy 2349-g infant who required a permanent pacemaker.

CONCLUSION: Reassuring antepartum testing and normal growth in pregnant women with anti-Ro/SSA antibodies and congenital heart block may allow expectant management until fetal maturity.

In Brief

Congenital heart block and severe fetal bradycardia, with a structurally normal heart, is managed successfully with standard fetal testing until documentation of fetal lung maturity.

Author Information

Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, Texas; and Louisiana State University, Shreveport, Louisiana

Address reprint requests to: Allahyar Jazayeri, MD, PhD, Medical Director, Maternal-Fetal Medicine, Bellin Health Hospital Center, 774 South Webster Avenue, Green Bay, WI 54305; E-mail: allahyar@new.rr.com.

Received February 6, 2002. Received in revised form March 14, 2002. Accepted March 21, 2002.

© 2002 The American College of Obstetricians and Gynecologists