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.
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.
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: firstname.lastname@example.org.
Received February 6, 2002. Received in revised form March 14, 2002. Accepted March 21, 2002.