Prophylactic IVIG and dexamethasone may help prolong pregnancy in women with anti-SSA/Ro and anti-SSB/La antibodies and a history of fetal complete heart block.
Supports prophylactic IVIG and dexamethasone in recurrent fetal heart block; hypothesis-generating and requires controlled trials before any practice change.
We report a case of complete fetal heart block in a 35-year-old Chinese woman known to be positive for anti-SSA/Ro and anti-SSB/La antibodies. She had fetal hydrops leading to intrauterine death in her first pregnancy Prophylactic intravenous immunoglobulin, given at 14 and 18 weeks' gestation, as well as oral dexamethasone, commenced at 24 weeks' gestation, allowed continuation of the pregnancy until 34 completed weeks of gestation. An external pacemaker was inserted in the baby on the first day of life. Two-and-a-half months later, a permanent pacemaker was inserted.
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Wong et al. (2001) studied this question.
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