2020 Volume 56 Issue 1 Pages 113-117
Fetal complete atrioventricular block（CCAVB）occurs in 1 to 2％ in anti-SS-A antibody positive pregnant women.
Case: A 35-year-old woman was gravidity 2 para 1.
She has not been diagnosed with Sjogren’s syndrome before pregnancy.
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.
In addition, maternal anti-SS-A / SS-B antibody was positive and Sjogren’s syndrome was diagnosed.
Ritodrine hydrochloride instillation was started and it was evaluated fetal heart function with CVPS and maintained 8 points or more.
At the 37th week and 5th pregnancy, a selective caesarean section was performed.
The baby was 2878g, male, Apgar score is 5/5 points. Umbilical arterial blood pH 7.289.
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.
