Isolated congenital atrioventricular block diagnosed<i>in utero</i>: Natural history and outcome

Breur, Johannes M.P.J.; Kapusta, Livia; Stoutenbeek, P.; Visser, Gerard H.A.; Berg, Paul van den; Meijboom, E. J.

doi:10.1080/14767050802052786

Cited by 25 publications

(18 citation statements)

References 30 publications

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“…14 Detected in utero, congenital AV block has been associated with the development of hydrops in about 40% of cases, with a third resulting in stillbirth. 14 The presence of antiphospholipid antibodies and a prior fetal loss are also significant predictors of subsequent stillbirth in SLE. Antiphospholipid antibodies can be found in over one-third of SLE patients and are associated with procoagulant actions resulting in an increased risk of thrombosis and potential damage to the uteroplacental vasculature.…”

Section: Slementioning

confidence: 99%

Maternal Medical Disease and Stillbirth

Coletta

Simpson

2010

Clinical Obstetrics &Amp; Gynecology

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Stillbirth is one of the most common adverse pregnancy outcomes in the United States. Although there are certain maternal medical conditions that increase the risk of antepartum fetal death, advances in medical and obstetric care have decreased its incidence. The objective of this review was to examine the current stillbirth rates reported in pregnancies complicated by common medical diseases such as hypertension, diabetes, obesity, systemic lupus erythematosus, chronic renal disease, thyroid disorders, and cholestasis of pregnancy. Early diagnosis remains the key to provide increased surveillance and possible intervention to further decrease the likelihood of stillbirth.

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Section: Slementioning

confidence: 99%

Maternal Medical Disease and Stillbirth

Coletta

Simpson

2010

Clinical Obstetrics &Amp; Gynecology

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“…In the following years, multiple studies elucidated the risk factors used to determine who should have a pacemaker implanted. Pacing is now recommended immediately after birth in the presence of a ventricular rate below 55 beats/min and fetal hydrops [4,5], a low heart rate, poor growth and development, tiredness and irritability in infancy and childhood, prolonged QTc, a slow junctional rate with junctional exit block and alternating ventricular pacemaker as detected by ambulatory electrocardiography, a gradually decreasing ventricular rate with increasing age, ventricular dilatation and dysfunction, mitral regurgitation, a low physical working capacity test, presyncope and Adams-Stokes attacks [6][7][8][9][10][11][12][13].…”

Section: Whom and When To Pace?mentioning

confidence: 99%

Controversies in the therapy of isolated congenital complete heart block

Dolara¹,

Favilli²

2010

Journal of Cardiovascular Medicine

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Controversies in the therapy of congenital complete heart block are reviewed in terms of the timing of pacemaker implantation, the type and complications of pacing and its role in the presence of myocardial dysfunction. Drug treatment may be useful in selected cases in the presence of pleural effusions, ascites and hydrops of the fetus, but have no effect on complete heart block. Administration of fluorinated steroids in anti-Ro antibody-positive mothers with the aim of preventing complete heart block has given controversial results. Because of the variety of the clinical presentations, especially in regard to pacing therapy, it is mandatory to refer patients with congenital complete heart block to specialized centers with adequate resources and experienced personnel.

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“…Complete atrioventricular block (CAVB), also known as third-degree heart block, in a human fetus is a rare condition associated with significant mortality if comorbidity is present [5,17,27,32]. Fetal bradycardia due to complete heart block can progress in utero to hydrops fetalis, which usually results in fetal demise or neonatal death due to extreme prematurity or multi-organ system failure [21,13].…”

Section: 0 Introductionmentioning

confidence: 99%

Minimally invasive implantable fetal micropacemaker: mechanical testing and technical refinements

Zhou

Vest

Peck

et al. 2016

Med Biol Eng Comput

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This paper discusses the technical and safety requirements for cardiac pacing of a human fetus with heart failure and hydrops fetalis secondary to complete heart block. Engineering strategies to meet specific technical requirements were integrated into a systematic design and implementation consisting of a novel fetal micropacemaker, a percutaneous implantation system, and a sterile package that enables device storage and recharging maintenance in a clinical setting. We further analyzed observed problems on myocardial fixation and pacing lead fatigue previously reported in earlier preclinical trials. This paper describes the technical refinements of the implantable fetal micropacemaker to overcome these challenges. The mechanical performance has been extensively tested to verify the improvement of reliability and safety margins of the implantation system.

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Isolated congenital atrioventricular block diagnosedin utero: Natural history and outcome

Cited by 25 publications

References 30 publications

Maternal Medical Disease and Stillbirth

Maternal Medical Disease and Stillbirth

Controversies in the therapy of isolated congenital complete heart block

Minimally invasive implantable fetal micropacemaker: mechanical testing and technical refinements

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