Frontiers in Cardiovascular Medicine (Nov 2021)

Successful Prevention of Fetal Autoimmune-Mediated Heart Block by Combined Therapies With Hydroxychloroquine and Intravenous Immunoglobulin: A Case Report

  • Li Zhao,
  • Yan Zhou,
  • Chuan Wang,
  • Yifei Li,
  • Qi Zhu,
  • Yimin Hua,
  • Lina Qiao,
  • Jinlin Wu,
  • Kaiyu Zhou

DOI
https://doi.org/10.3389/fcvm.2021.759260
Journal volume & issue
Vol. 8

Abstract

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A fetal autoimmune-mediated atrioventricular block is a passively acquired autoimmune disease in which maternal autoantibodies enter the fetal circulation via the placenta and subsequently cause inflammation and fibrosis of the atrioventricular node. Once fetal autoimmune-mediated atrioventricular block occurs, it only takes a short time to progress from first-degree atrioventricular block to complete atrioventricular block, meaning that the damage is often irreversible. Autoimmune—associated AVB, a rare but life—threatening disorder, occurs in 2–5% of pregnancies with positive anti—Ro/SSA (the most common one) and La/SSB antibodies. The perinatal mortality of neonates with AVB outlined in research is approximately 30%. Thus far, for autoimmune-associated AVB fetuses, currently used treatments include corticosteroids, hydroxychloroquine, intravenous immunoglobulin (IVIG), b—sympathomimetic agent, and even plasma exchange. Currently, approaches for preventing the progression and recurrence of a fetal atrioventricular block are still controversial. Here, we reported a baby of successful prevention from the fate of the fetal atrioventricular block by adopting prophylactic comprehensive prenatal therapy.

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