Key result
In a series of 5 fetuses with congenital complete atrioventricular block, one died in utero, one had partial recovery of conduction, and three required postnatal epicardial pacemaker implantation.
Why the study?
Although maternal antibodies linked to congenital atrioventricular block are common in pregnant women, fetal pathology is rare, prompting this analysis of intrauterine cases and their follow-up protocol.
Case Report (n=5)
No
In fetuses with congenital complete atrioventricular block, completing the evaluation of ventricular function with longitudinal speckle tracking may help establish therapeutic behavior and timing of pacemaker implantation.
Supports protocolized follow-up in fetal CAVB; leaves open validation in larger prospective cohorts.
AIM: Congenital atrioventricular block (CAVB) is an immunological condition, secondary to the transfer of maternal Ig G antibodies from seropositive mothers. Although the presence of these antibodies is high among pregnant women, the preva-lence of this fetal pathology is low. The aim of this paper is to analyze a series of cases with intrauterine diagnosis of CAVB and to present their follow-up protocol. MATERIAL AND METHOD: In the period between 2013-2020, five fetuses were diagnosed and followed up in the Pediatric Cardiology Clinic. In each of the cases, assessment of the hemodynamic status was done by calculation of the fetal cardiovascular profile score (CVPS). In the last cases the follow-up protocol was supplemented with longitudinal speckle tracking evaluation of the ventricular function. RESULTS: In the present series, intrauterine death occurred in one case; in another case resumption of atrioventricular conduction was observed. Epicardial pacemaker implantation was required in three of the patients. CONCLUSION: Completing the evaluation of ventricular function with the longitudinal speckle tracking method in fetuses and newborn patients with congenital atrioventricular block may play an important role in establish-ing therapeutic behavior.
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Gozar et al. (2020) conducted a case report in Congenital complete atrioventricular block (n=5). Dexamethasone was evaluated on Survival and atrioventricular conduction recovery. In a series of 5 fetuses with congenital complete atrioventricular block, one died in utero, one had partial recovery of conduction, and three required postnatal epicardial pacemaker implantation.
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