Abstract
Pregnancies in women with autoantibodies against Ro/SSA and/or La/SSB may be associated with permanent and treatment resistant fetal atrioventricular (AV) block. We describe a patient with primary S ogren's syndrome and anti-Ro (60 kDa and 52 kDa) and anti-La autoantibodies, in whom fetal bradycardia with second-degree AV block was detected at 19 + 0 weeks of gestation. Maternal treatment with dexamethasone (4 mg/day po) was started 2 days later. The baby's heart rate improved gradually, returning to normal after about 6 weeks of treatment. Our case illustrates the importance of close monitoring of the fetal heart rate in risk-pregnancies from about week 16 of gestation and initiation of dexamethasone treatment without delay when a block is detected.
MeSH terms
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Adult
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Anti-Inflammatory Agents / administration & dosage*
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Anti-Inflammatory Agents / adverse effects
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Antibodies, Antinuclear / adverse effects
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Antibodies, Antinuclear / blood
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Antibodies, Antinuclear / immunology
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Dexamethasone / administration & dosage*
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Dexamethasone / adverse effects
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Female
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Fetal Diseases / diagnosis
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Fetal Diseases / drug therapy
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Fetal Diseases / immunology*
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Heart Block / congenital*
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Heart Block / drug therapy
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Heart Block / immunology*
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Humans
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Pregnancy
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Pregnancy Complications / diagnosis
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Pregnancy Complications / drug therapy
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Pregnancy Complications / immunology*
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Sjogren's Syndrome / complications*
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Sjogren's Syndrome / immunology
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Sjogren's Syndrome / physiopathology
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Treatment Outcome
Substances
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Anti-Inflammatory Agents
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Antibodies, Antinuclear
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SS-A antibodies
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Dexamethasone