Reversal of Fetal Heart Block in Antibody-Positive Mother After Hydroxychloroquine and Dexamethasone

Mehar Hoda, William Scott, Kavita Sharma, Elaine Duryea, Catherine Ikemba

Research output: Contribution to journalArticlepeer-review

Abstract

Maternal autoantibody-related complete heart block in the fetus is considered irreversible. During prenatal care for a 25-year-old nulliparous Hispanic woman with newly diagnosed nephrotic-range proteinuria and positive anti-nuclear antigen antibody, complete fetal heart block with a ventricular rate of 60 beats per minute was detected on a fetal echocardiogram at 28-week gestation. A small pericardial effusion and ascites were noted consistent with fetal hydrops. Dexamethasone and hydroxychloroquine were initiated. Fetal rhythm improved to Mobitz type 1 second-degree heart block, with a ventricular rate of 91 beats per minute. The fetus was born prematurely at 34-week gestation with second-degree heart block which improved to first-degree heart block prior to hospital discharge. First-degree heart block persisted at 2 years of age with a P-R interval of 185 ms. Transplacental treatment with dexamethasone and hydroxychloroquine was associated with sustained reversal of complete heart block to sinus rhythm.

Original languageEnglish (US)
JournalPediatric Cardiology
DOIs
StateAccepted/In press - 2022

Keywords

  • Anti-Ro antibody
  • Atrioventricular block
  • Heart block
  • Hydroxychloroquine
  • Maternal lupus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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