Prevention of recurrence of congenital heart block with intravenous immunoglobulin and corticosteroid therapy: Comment on the editorial by Buyon et al

Kaaja, Risto; Julkunen, Heikki

doi:10.1002/art.10716

Cited by 65 publications

(41 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…31 The alternative therapies, as evidenced by a few case reports, include plasmapheresis, 31 intravenous immunoglobulins, and β-sympathomimetics. 32 In most cases, complete heart block requires a pacemaker implantation in the infant, preferably in the neonatal period.…”

Section: Antenatal Managementmentioning

confidence: 99%

Sjögren Syndrome and Pregnancy: A Literature Review

Gupta

2017

TPJ

View full text Add to dashboard Cite

Section: Antenatal Managementmentioning

confidence: 99%

Sjögren Syndrome and Pregnancy: A Literature Review

Gupta

2017

TPJ

View full text Add to dashboard Cite

“…Once third degree HB is identified, it is irreversible despite of therapy with dexamethasone one or IVIG. 7 For fetuses with CCHB, Biophysical profile (BPP) score alone is not a good indicator of fetal wellbeing. The 'non stress test' of BPP which shows fetal heart rate variability in the absence of uterine contractions, believed to be an indicator of fetal distress cannot be utilized in fetuses with CHB, as ventricular rate in CHB doesn't vary with fetal distress.…”

Section: Discussionmentioning

confidence: 99%

Resolved Mystery of Difficult Neonatal Resuscitation

Manikyamba¹,

Madhavi²,

Padmavathi³

et al. 2015

jemds

View full text Add to dashboard Cite

Most common cause of bradycardia in newborn is sinus bradycardia due to hypoxia and acidosis. Complete Congenital Heart block (CCHB)is a rare cause of neonatal bradycardia. We are here with reporting a rare case of NLE, which presented with birth asphyxia and bradycardia, not responding to resuscitation. The baby had CHB with cardiogenic shock and was initially stabilized and sent for pediatric cardiac center for pacemaker implantation.

show abstract

“…Indeed, it took more than 7 years to gather 70 fetuses at risk for AVB in the present national multicenter study. Kaaja and Julkunen,26 reporting their experience using intravenous immunoglobulin and corticosteroids in pregnancies of women who had previous children with complete AVB, calculated that to evaluate the efficacy of treatment, a randomized, placebo-controlled trial of 70 patients in each study arm would be necessary to detect a decrease in the recurrence rate from 17% to 3% in this high-risk population. Thus, given the rarity of this condition, only a very large multicenter or even multinational study would achieve the sample size necessary to answer these questions.…”

Section: Discussionmentioning

confidence: 99%

“…On diagnosis of fetal first-degree AVB, dexamethasone (4 mg per day) was administered to the mother of the affected fetus until delivery, according to the clinical indication of treatment in prenatal AVB. 16,18,20,21,25,26 One patient had received prednisone (50 mg) for up to 34 weeks because of SLE exacerbation. Her treatment was switched to intramuscular betamethasone, followed by administration of dexamethasone (4 mg per day) initiated 72 hours later and continued to delivery.…”

Section: Treatmentmentioning

confidence: 99%

Early Diagnosis and Treatment of Atrioventricular Block in the Fetus Exposed to Maternal Anti-SSA/Ro-SSB/La Antibodies

et al. 2009

View full text Add to dashboard Cite

Background-A fetus exposed to maternal anti-SSA/Ro or anti-SSB/La antibodies (or both) may develop complete atrioventricular block (AVB), which results in high prenatal and postnatal morbidity and mortality. Until recently, only high-grade AVB could be diagnosed in utero. The tissue velocity-based fetal kinetocardiogram (FKCG) enables accurate measurement of AV conduction time and diagnosis of low-grade AVB. In the present multicenter observational study, we used FKCG to detect first-degree AVB in fetuses at risk. Methods and Results-FKCG was performed in 70 fetuses of 56 mothers who were positive for anti-SSA/Ro and/or anti-SSB/La. Fetuses were monitored with weekly FKCG from 13 to 24 weeks' gestation, followed by monthly assessments until delivery in unaffected fetuses and weekly assessments in affected fetuses. AV conduction in 70 at-risk and 109 normal fetuses was compared. FKCG was obtained readily in all fetuses; 6 showed first-degree AVB (AV conduction time Ͼ2 z scores above normal mean) at 21 to 34 gestational weeks. Immediate maternal treatment with dexamethasone resulted in normalization of AV conduction in all affected fetuses within 3 to 14 days. AV conduction time in the remaining 64 untreated fetuses remained normal throughout gestation. The ECG PR interval immediately after birth was normal in all affected newborns. No child developed AVB or cardiomyopathy in the subsequent 1-to 6-year (median 4-year) follow-up. Conclusions-The present findings suggest that an FKCG can detect first-degree AVB in the fetus exposed to maternal anti-SSA/Ro or anti-SSB/La antibodies (or both). Dexamethasone given on detection was associated with normalized AV conduction in fetuses with first-degree AVB. No fetus in the present study developed complete prenatal or postnatal AVB.

show abstract

Prevention of recurrence of congenital heart block with intravenous immunoglobulin and corticosteroid therapy: Comment on the editorial by Buyon et al

Cited by 65 publications

References 9 publications

Sjögren Syndrome and Pregnancy: A Literature Review

Sjögren Syndrome and Pregnancy: A Literature Review

Resolved Mystery of Difficult Neonatal Resuscitation

Early Diagnosis and Treatment of Atrioventricular Block in the Fetus Exposed to Maternal Anti-SSA/Ro-SSB/La Antibodies

Contact Info

Product

Resources

About