Volume : I, Issue : VI, March - 2012

Antenatal Diagnosis and Successful Delivery of a Fetus with Complete Heart Block

Anju Kumari Rani, Aditya Kapoor, Deepa Kapoor

Abstract :

We describe here a case of a 26 years old primigravida, who was diagnosed antenatally to have fetal complete heart block ( CHB) by fetal echocardiography, followed by successful normal vaginal delivery. Patient had a regular antenatal checkup without any diagnosed abnormality till almost 30 weeks of gestation. At 30 weeks of gestation an irregular and fetal heart rate was detected on clinical examination. Ultrasonography and fetal echocardiogram was performed which revealed a complete heart block ( atrial rate of 140/minute and a ventricular rate of 50 / minute ), without any evidence of cardiac anomaly or sign of fetal hydrops. Since there was no evidence of hydrops, it was decided to follow the case with echocardiogram and electively pace the baby after delivery. Oral prednisolone ( 4mg/kg body weight ) was started to arrest the further damage to the fetal cardiac conduction system The fetal heart rate remained stable at 50 – 55 / minute. On futher evaluation Anti Ro Anti nuclear antibody (ANA) test for maternal lupus was found to be positive. At 37 week patient went into spontaneous labour and she delivered a female child with an APGAR score of 8 at 1 minute, under close monitoring of interventional cardiologist. The electrocardiogram after birth revealed complete heart block ( CHB). It was decided to implant an epicardial ( VVI ) single chamber pacemaker. The parent of the child declined the option of pacemaker implantation. Baby had a sudden cardiac arrest 3 days later, possibly due to cardiac arrhythmia. SUMMARY : A rare case of fetal congenital heart block diagnosed antenatally in a woman with autoimmune disease, planned for elective ventricular pacing after delivery. The case highlights importance of team work in managing these types of cases in a tertiary care hospital.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Anju Kumari Rani, Aditya Kapoor, Deepa Kapoor Antenatal Diagnosis and Successful Delivery of a Fetus with Complete Heart Block Indian Journal of Applied Research, Vol.I, Issue.VI March 2012

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