Why the study?
Current practice guidelines advise against prenatal surveillance of antibody-exposed fetuses and steroid treatment of fetal AV block, whereas recent research endorses a more preemptive approach.
Answers are grounded in this paper and cite their sources.
Emerging evidence supports preemptive surveillance and steroid treatment for fetal complete AV block, challenging current maternal-fetal medicine guidelines.
Complete atrioventricular block (CAVB) is a disease of the developing fetus that mainly results from the transplacental transfer of high-titer maternal anti-Ro/SSA autoantibodies.About 2%-4% of antibody-exposed fetuses have manifestations of cardiac neonatal lupus (CNL), such as AV block (AVB), carditis, and endocardial fibroelastosis (EFE).CAVB, the most common CNL manifestation, carries significant mortality and morbidity risks, with most deaths occurring perinatally and >70% of survivors requiring permanent pacing beginning during infancy.Current practice guidelines including by the Society for Maternal-Fetal Medicine advise against the prenatal surveillance of antibodyexposed fetuses and against steroid treatment of fetal AVB because of their "unproven benefit." 1 The latest research findings, however, endorse a more preemptive surveillance and treatment approach for CNL with the potential of life-altering and life-saving consequences for affected children.
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Jaeggi et al. (2025) conducted a review in immune-mediated congenital complete atrioventricular block in utero. Preemptive surveillance and steroid treatment was evaluated.
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