A fetus was found to have congenital heart block what should be evaluated in the mother?
Ans. (c) SLERef- Williams Obstetrics 25th Ed; Page No-1139-42* Congenital heart block develops almost exclusively in fetuses of women with antibodies to the SS-A or SS-B antigens for Anti-Ro (SS-A) antibody.* Prevalence rate with these antibodies are 30-49%.* Fetal cardiac monitoring is performed between 18 and 26 weeks' gestation in pregnancies with either of these antibodies.* Incidence of fetal myocarditis is only 2-3%; if these antibodies are present.Extra MileAutoantibodies produced in patients with systemic lupus erythematosus (SLE)AntibodyClinical associationsPrevalenceAntihistoneCommon in drug-induced lupus70%Anti-Ro (SS-A)Associated with sicca syndrome, predisposes to cutaneous lupus, neonatal lupus with heart block, reduced risk of nephritis30-49%Anti-La (SS- B)Associated with anti-Ro10-35%Anti-dsDNAMay correlate with disease activity, nephritis, and vasculitis Anti- RNPhigh titers associated with rheumatic syndromes33-40%Antinuclear (ANA)Best screening test, multiple antibodies; a second negative test makes SLE unlikely84-98Anti-Sm (Smith)Specific for SLE25-38%Antiphospho- lipidLupus anticoagulant and anticardiolipin anti bodies associated with thrombosis, fetal loss, thrombocytopenia, valvular heart disease; false positive test for syphilis21-50%AntierythrocyteDirect Coo m b s test, may develop hemolysis60%
Apla Syndrome
Congenital heart defects
SLE
Hemolytic anemia
Medical & Surgical Illness Complication Pregnancy