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Outcomes of fetal echocardiographic surveillance in anti‐SSA exposed fetuses at a large fetal cardiology center
Author(s) -
Krishnan Anita,
Arya Bhawna,
Moak Jeffrey P.,
Donofrio Mary T.
Publication year - 2014
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4454
Subject(s) - medicine , pericardial effusion , fetal echocardiography , cardiology , fetus , sinus bradycardia , heart block , atrioventricular block , bradycardia , prenatal diagnosis , pregnancy , electrocardiography , heart rate , biology , blood pressure , genetics
BACKGROUND Echocardiography screening in anti‐SSA antibody exposed fetuses is controversial. OBJECTIVE The aim of this study is to evaluate utility of fetal echocardiography in anti‐SSA exposure. METHODS Echocardiograms performed over 9 years for maternal anti‐SSA exposure were reviewed for atrioventricular (AV) block, cardiomyopathy, arrhythmias, effusion, valve abnormalities, or other abnormalities identified by the echocardiographer. Fetuses with AV block referred to our institution and subsequently found to be anti‐SSA exposed were also identified. RESULTS Six hundred thirty six echocardiograms were performed on 140 fetuses (Cohort 1) of 134 women screened for maternal anti‐SSA +/− anti‐SSB antibodies. No fetuses developed second or third‐degree AV block or cardiomyopathy (odds ratio 0.1, CI 0.0051 to 1.9410, p = 0.13). Dexamethasone was administered to three fetuses for sinus bradycardia, echogenicity near AV node, and ventricular systolic dysfunction with valve regurgitation; all normalized. Screening echocardiograms identified: sinus bradycardia ( n = 1), PR prolongation ( n = 5), premature atrial contractions ( n = 3), valve regurgitation ( n = 24), echogenic myocardium ( n = 4), and pericardial effusion ( n = 1). Isolated tricuspid regurgitation and first‐degree AV block did not progress. Nine cases of SSA‐mediated AV block (Cohort 2) were referred after heart block developed. CONCLUSIONS Serial fetal echocardiography in anti‐SSA exposed fetuses did not detect AV block. In rare cases, dexamethasone treatment may have affected disease course. © 2014 John Wiley & Sons, Ltd.