Fetal complete atrioventricular block and maternal Sjogren’s syndrome diagnosed by fetal advanced bradycardia during pregnancy examination: A case report

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  • Okuyama Ayumi
    Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital
  • Dohi Satoshi
    Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital
  • Seo Kohei
    Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital
  • Ichizuka Kiyotake
    Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital
  • Nagatuka Masaaki
    Department of Obstetrics and Gynecology, Showa University Northern Yokohama Hospital

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  • 妊婦健診時の胎児高度徐脈を契機に胎児完全房室ブロックと母体シェーグレン症候群が判明した一例

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Abstract

<p> Fetal complete atrioventricular block（CCAVB）occurs in 1 to 2％ in anti-SS-A antibody positive pregnant women.</p><p> Case: A 35-year-old woman was gravidity 2 para 1.</p><p> She has not been diagnosed with Sjogren’s syndrome before pregnancy.</p><p> In the previous pregnancy, she was performed an emergency caesarean section because of NRFS. In this pregnancy, she was admitted because of her fetal advanced bradycardia at the examination of 30 weeks’ gestation. The fetal atrium / ventricle beat rate was 136/63 bpm and diagnosed as CCAVB.</p><p> In addition, maternal anti-SS-A / SS-B antibody was positive and Sjogren’s syndrome was diagnosed.</p><p> Ritodrine hydrochloride instillation was started and it was evaluated fetal heart function with CVPS and maintained 8 points or more.</p><p> At the 37th week and 5th pregnancy, a selective caesarean section was performed.</p><p> The baby was 2878g, male, Apgar score is 5/5 points. Umbilical arterial blood pH 7.289.</p><p> The Baby’s heart rate was 49 bpm at birth, and bradycardia was continuing, so a pacemaker implant surgery went to the day-old 45. It is important to always be conscious of fetal arrhythmia during pregnancy examination and to evaluate fetal heart function appropriately, because there are undiagnosed antibody positive pregnant women and CCAVB may develop even in the late pregnancy as in this case.</p>

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