Abstract
Background: Complete Congenital Heart Block (CCHB) is a rare disease of the newborn that carries significant morbidity and mortality. CCHB can be diagnosed early or late in life. In newborns, it is usually associated with maternal autoantibodies or a congenital cardiac structural abnormality. The most common presentation of CCHB is bradycardia that can be diagnosed by an electrocardiogram. Results: This is a case report of a male infant born to a mother with an autoimmune disease, Systemic Lupus Erythematosus (SLE), who was found to have third degree heart block at birth. Conclusion: Early diagnosis and prompt management of the case is important for a better prognosis and prevention of associated complications. Neonates with CCHB should be managed at a tertiary care center and the only definite treatment is insertion of a pacemaker. Moreover, prenatal diagnosis and specific obstetric counseling of pregnant women with SLE along with careful monitoring with serial ultrasonography and echocardiography are of paramount importance in prevention of the disease in subsequent offspring.
Highlights
Complete Congenital heart block (CCHB) is a rare clinical entity present in about 1 in 20,000 live births and has significant morbidity and mortality.[1]
We present a rare case of Complete Congenital Heart Block (CCHB) in a newborn associated with maternal Systemic Lupus Erythematosus (SLE)
It is necessary to implement: 1) Health education and creating awareness among high risk populations, 2) Emphasize good antenatal care and proper screening, especially in underprivileged populations, because frequent assessment of fetal heart rate by echocardiography during pregnancy is beneficial for a patient with positive anti-Ro and anti-La antibodies, and 3) implementing proper obstetric counseling and support to the family
Summary
Complete Congenital heart block (CCHB) is a rare clinical entity present in about 1 in 20,000 live births and has significant morbidity and mortality.[1] It generally occurs due to the presence of maternal auto-antibodies, anti-Ro/SSA and anti-La/SSB, that are transferred across the placenta to the fetus and affect the fetal heart. A 3-days-old full-term male infant, born out of a consanguineous marriage by normal vaginal delivery with a birth weight of 3,330 g, presented with bradycardia (heart rate of 40-65 beats/min) and respiratory distress for which he was admitted to special care baby unit (SCBU) His mother, Gravida 6 and Para 6, had a past medical history significant for Systemic Lupus Erythematosus (SLE) as positive anti-Ro/SS-A antibodies had been discovered 5 years ago.
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