Key result
Hydroxychloroquine prevents recurrence of congenital heart block in anti-SSA-affected pregnancies, while corticosteroids and IVIG may be used for second-degree block, though complete block remains permanent.
Why the study?
Immune-mediated complete heart block causes fetal bradycardia with high morbidity and mortality, yet rare incidence and limited experience lead to a lack of standard treatment protocols.
Answers are grounded in this paper and cite their sources.
Hydroxychloroquine is recommended to prevent recurrence of immune-mediated congenital heart block, whereas treatment of established block with steroids or IVIG remains controversial.
Immune-mediated complete heart block (CHB) is one of the most common reasons of fetal bradycardia, burdened with high morbidity, fetal mortality rate up to 19%.Even 70% of survivors require pacemaker implantation after birth or in early childhood.The recurrence rate of CHB in a subsequent pregnancy reaches 19%.Rare incidence of disease in population, limited experience, lack of standard treatment protocols are main issues.This article is a clue to therapeutic indications and options, based on literature review covering years: 2000-2020.
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Opacian-Bojanowska et al. (2022) conducted a review in Congenital heart block in fetuses of anti-SSA/SSB-positive mothers. Various treatments (hydroxychloroquine, corticosteroids, IVIG, beta-mimetics) was evaluated. Hydroxychloroquine prevents recurrence of congenital heart block in anti-SSA-affected pregnancies, while corticosteroids and IVIG may be used for second-degree block, though complete block remains permanent.
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