Open AccessManagement of fetal congenital heart block in pregnancies with anti-Ro antibodies
Author(s) -
Anca Maria Panaitescu,
Gheorghe Peltecu,
Nicolae Gică
Publication year - 2021
Publication title -
romanian journal of rheumatology
Language(s) - English
Resource type - Journals
eISSN - 2069-6086
pISSN - 1843-0791
DOI - 10.37897/rjr.2021.4.2
Subject(s) - medicine , hydroxychloroquine , fetus , antibody , pregnancy , heart block , population , obstetrics , immunology , electrocardiography , disease , environmental health , covid-19 , biology , infectious disease (medical specialty) , genetics
Anti-Ro antibodies are detected frequently in the general population, but more so in patients with autoimmune conditions as Sjögren’s syndrome and systemic lupus erythematous (SLE). During pregnancy, anti-Ro antibodies can cross the placenta by hijacking physiological mechanisms and can have deleterious effects on the fetus. Administration of hydroxychloroquine (HCQ) to pregnant women with documented anti-Ro antibodies has been shown to prevent congenital heart block (CHB). Serial fetal ultrasound scans and echocardiograms are controversial in pregnant women with anti-Ro antibodies. When complete CHB is diagnosed, this is irreversible and can lead to fetal heart failure, hydrops, and death. After delivery, babies with complete CHB require pacemaker. In the presence of maternal anti-Ro antibodies, there is a high risk of recurrence of CHB for future pregnancies, if there is a previously affected child. Adequate counselling and prophylactic treatment with HCQ should be encouraged.