Perinatal Outcome of Fetal Atrioventricular Block : One-Hundred-Sixteen Cases From a Single Institution

Fetal atrioventricular (AV) block is an uncommon lesion with significant mortality. Because of the rarity of this disorder, the natural course, extensive evaluation of untreated fetuses, and late follow-up remain unclear. Of the 116 consecutive cases of fetal AV block studied from 1988 to 2006, only...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2008-09, Vol.118 (12), p.1268-1275
Main Authors: LOPES, Lilian M, PENHA TAVARES, Glaucia Maria, DAMIANO, Ana Paula, BORGES LOPES, Marco Antonio, DEMARCHI AIELLO, Vera, SCHULTZ, Regina, ZUGAIB, Marcelo
Format: Article
Language:English
Subjects:
Atrioventricular Block - diagnostic imaging
Atrioventricular Block - therapy
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Echocardiography, Doppler, Color - methods
Female
Fetal Diseases - diagnostic imaging
Fetal Diseases - therapy
Follow-Up Studies
Hospitals, University - trends
Humans
Infant
Medical sciences
Perinatal Care - methods
Perinatal Care - trends
Pregnancy
Retrospective Studies
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Treatment Outcome
Ultrasonography, Prenatal - methods
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Summary:Fetal atrioventricular (AV) block is an uncommon lesion with significant mortality. Because of the rarity of this disorder, the natural course, extensive evaluation of untreated fetuses, and late follow-up remain unclear. Of the 116 consecutive cases of fetal AV block studied from 1988 to 2006, only 1 was terminated, and 75% were live births. Fifty-nine cases of AV block were associated with major structural heart disease, mainly left atrial isomerism (n=40), with only 26% of neonatal survivors. Of the 57 fetuses with normal cardiac anatomy, 41 (72%) were positive for maternal antinuclear antibodies, and 32 of these seropositive mothers did not receive any treatment. This untreated group had live-birth and 1-year infant survival rates of 93% and 90% [corrected], respectively. Five fetuses from seronegative mothers showed regression to sinus rhythm during pregnancy. The presence of major structural heart disease, hydrops, an atrial rate
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.107.735118