The impact of treatment of the fetus by maternal therapy on the fetal and postnatal outcomes for fetuses diagnosed with isolated complete atrioventricular block

Abstract

The outcome in our cases was mainly dependent on the presence and degree of fetal cardiac failure. Treatment of the fetus by maternal administration of steroids did not result in any regression of the conduction disorder, but had a favourable effect on fetal hydrops.

Fetal Congenital Complete Atrioventricular Block in a Mother with Isolated Serum Anti-SSA/Ro and Anti-SSB/La Antibodies

“…12,13 There is no consensus on optimal time to quit treatment and the majority of practitioners continue treatment until delivery. 14,15 Considering potential for fetal adverse effects of long-term steroid therapy, including neurodevelopmental and growth abnormalities, further studies on the best time to discontinue treatment is warranted. 7 When we first noticed the fetal pericardial effusion, we started oral dexamethasone treatment.…”

Current Status of Fetal Cardiac Intervention

“…AV block in the fetus generally occurs in association with either maternal autoimmune disease, malformation syndromes such as heterotaxy, or L-loop transposition of the great arteries. 29–32 …”

Isoproterenol infusion for treatment of refractory symptomatic bradycardia in parturients with congenital complete heart block

“…Fortunately, human studies demonstrating undesirable effects of isoproterenol in pregnant women or their fetuses are rare, 6,8 and studies show that arrhythmias do not develop in fetuses where isoproterenol infusions have been utilized to increase maternal heart rate. [9][10][11] The use of isoproterenol to terminate fetal congenital complete heart block provides additional useful safety data in mothers and fetuses. 10,11 We recommend initiating isoproterenol infusions at the smallest recommended dose with continuous maternal and fetal monitoring.…”

“…[9][10][11] The use of isoproterenol to terminate fetal congenital complete heart block provides additional useful safety data in mothers and fetuses. 10,11 We recommend initiating isoproterenol infusions at the smallest recommended dose with continuous maternal and fetal monitoring. Studies have shown the chronotropic effect of isoproterenol is reduced in term pregnant women; however, a linear response has still been demonstrated with slightly higher doses.…”