The most important prognostic factor for congenital AVB is the association with CHD. In utero treatment remains questionable.
Objectives:To study the course and outcome of fetuses with congenital Atrial Ventricular Block (AVB) over a 10-year period in a single centre. Methods: Retrospective study of all cases diagnosed prenatally with AVB of 2nd and 3rd degree between 2002 and 2012. All prenatal records, pre and postnatal echocardiographic reports, as well as follow-up data were reviewed. The clinical characteristics and outcome of fetal AVB were evaluated and compared with the data in the literature including the use of corticosteroids prenatally. Results: 91 cases of congenital AVB were referred to our unit over 10 years of which 62 cases were eligible for analysis and formed our study group. Associated congenital heart defect (CHD) was found in 17/62 (27.4%), maternal anti-bodies (AB) were present in 42/62 (67.7%). Fetal hydrops was present in 3 (4.8%) cases. Pregnancy was terminated in 12 (19.3%) cases including 8 and 2 cases with CHD and hydrops respectively. Among the 49 (79.3%) live-born neonates 4 (8.2%) died before 28 days of life, all had associated CHD, one needed to be paced at 2 years and died at 2.6 years of cardiac failure due to congestive cardiomyopathy. The only predictive factor for neonatal death was the association of CHD (OR for mortality: 15.6 [3.4; 78.4}, p < 10-4). 41 (63%) babies had a permanent pacemaker implanted. Mean (+/− SD) age at placement was 8.4 +/− 1.4 months. Congestive cardiomyopathy occurred in four cases. The median (interquartile range) age at follow up in our series was 3.4 (1.4-7.4) years. Among women with antibodies, twenty (44.4%) women received corticosteroids, sympathomimetics or both type of medication in 17 (37.8%), 1 (2.2%) and 2 (4.4%) cases respectively. No difference in outcome was found between these treatment groups. Conclusions:The most important prognostic factor for AVB is association with CHD. The treatment of congenital AVB remains a questionable intervention. A multicentre, randomized, controlled trial is recommended. OP04.03Natural history of bradyarrythmia with prenatally diagnosed polysplenia M. Kawataki Kanagawa Childrens Medical Center, Yokohama, JapanObjectives: Polysplenia is often complecated with bradyarrythmia. But its natural history is not kwown well. The aims of this study is to show the natural history of bradyarrythmia with prenatally diagnosed polysolenia. Methods: This retrospective study included 47 fetuses with prenatally diagnosed polysplenia. From the medical record of all polysplenia prenatally diagnosed from 1993 tol 2012, the time of diagnosis of bradyarrythmia, and implantation of permanent pacemaker and prognosis were studied. Results: Bradyarrythmia was diagnosed before birth in 19 cases (40%), after birth in 4 cases (9%), bradyarrthmia did not occurred in 24 cases (51%). In 19 cases of fetal bradyarrythmia, 4 cases (21%) died in utero, 12 cases (63%) received implantation of permanent pacemaker, 3 cases (16%) were followed without pacemaker. The time of pacemaker implantation was at birth in 4 cases, 11th day in 1 case, after 1 month in 5 cases. In...
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