Key result
In 23 anti-Ro/SSA antibody-positive pregnancies, fetal AV intervals remained within polynomial reference ranges, and postnatal ECGs demonstrated normal sinus rhythm without AV block in all children.
Why the study?
Maternal anti-Ro/SSA antibodies can cause fetal atrioventricular blocks, prompting investigation into whether previously published fetal AV interval reference ranges can exclude first-degree AV block.
Does plotting fetal AV intervals against polynomial reference ranges help exclude 1° AV block in anti-Ro/SSA antibody-positive pregnancies?
Observational (n=17)
No
Does plotting fetal AV intervals against polynomial reference ranges help exclude 1° AV block in anti-Ro/SSA antibody-positive pregnancies?
Fetal AV intervals in anti-Ro/SSA antibody-positive pregnancies without neonatal AV block generally fall within established polynomial reference ranges, suggesting potential utility in excluding 1° AV block.
May support reference-range monitoring in anti-Ro/SSA pregnancies; leaves open whether this excludes first-degree fetal AVB.
INTRODUCTION: Maternal anti-Ro/SSA antibodies can cause fetal atrioventricular blocks (AVB). This pilot study aims to apply previously published echocardiographic reference ranges of the fetal atrioventricular (AV) intervals in the setting of anti-Ro/SSA antibody-positive pregnancies in order to exclude a 1° AVB. MATERIALS AND METHODS: Between January 2018 and September 2022, we included all women with known anti-Ro/SSA antibodies followed up at the prenatal ultrasound department of the University Hospital of Bern. AV intervals were serially measured by two previously reported methods and plotted against previously created reference ranges. RESULTS: We included 23 pregnancies from 17 anti-Ro/SSA antibody-positive women with connective tissue diseases. 443 AV interval measurements were recorded between 16+3 and 38+4 weeks of gestation. 14 (3.2%) AV-intervals measured >150 ms, none measured >170 ms and 8 (1.8%) were found to be >95th percentile. In none of the pregnancies, serial AV-prolongations were noted. The postnatal electrocardiograms demonstrated normal sinus rhythm without AVB in all children. CONCLUSION: AV intervals of pregnancies followed up for anti-Ro/SSA antibodies without neonatal AVB lie within our published polynomial reference ranges. While diagnosing a 1° AVB remains controversial, more data are needed to prove that our reference ranges are helpful exclude a 1° AVB.
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Mosimann et al. (2023) conducted an observational in anti-Ro/SSA antibody-positive pregnancies (n=17). Fetal echocardiography for AV intervals was evaluated on Fetal atrioventricular (AV) intervals and incidence of 1° AV block. In 23 anti-Ro/SSA antibody-positive pregnancies, fetal AV intervals remained within polynomial reference ranges, and postnatal ECGs demonstrated normal sinus rhythm without AV block in all children.
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