Key result
Maternal administration of dexamethasone initiated at 27 weeks of gestation transiently improved a fetal complete atrioventricular block to a first-degree block after birth, though it recurred at four months.
Why the study?
Effective treatment for complete atrioventricular block caused by maternal anti-SS-A antibodies has not been established, and established complete atrioventricular block is usually considered irreversible.
Does maternal dexamethasone administration improve complete atrioventricular block in a fetus with maternal anti-SS-A antibodies when initiated at 27 weeks of gestation?
Case Report (n=1)
Does maternal dexamethasone administration improve complete atrioventricular block in a fetus with maternal anti-SS-A antibodies when initiated at 27 weeks of gestation?
Antenatal dexamethasone initiated at 27 weeks of gestation may transiently improve complete atrioventricular block caused by maternal anti-SS-A antibodies, potentially delaying the need for early pacemaker implantation.
Answers are grounded in this paper and cite their sources.
May support antenatal steroid trial in late anti-SS-A fetal AV block; leaves open need for prospective confirmation.
Maternal anti-SS-A antibodies may cause complete atrioventricular block or myocardial damage in a fetus. Effective treatment for this has not been established. Although antenatal steroids may be a treatment option for anti-SS-A antibody-related myocarditis or atrioventricular block, a complete atrioventricular block is usually considered irreversible once established. Previous reports have indicated that, in cases where antenatal steroids were effective for atrioventricular block, they were administered earlier in the pregnancy. Here we present a case where maternal steroid administration initiated from 27 weeks, which is beyond the recommended optimal treatment period, was effective in altering a complete atrioventricular block to a grade I atrioventricular block.
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Ishii et al. (2023) conducted a case report in Complete atrioventricular block due to maternal anti-SS-A antibody (n=1). Dexamethasone was evaluated on Improvement of atrioventricular block. Maternal administration of dexamethasone initiated at 27 weeks of gestation transiently improved a fetal complete atrioventricular block to a first-degree block after birth, though it recurred at four months.
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