Management with a staged approach of the premature hydropic fetus due to complete congenital heart block

Deloof, E; Devlieger, Hugo; Hoestenberghe, R. Van; Berghe, K. Van Den; Daenen, Willem; Gewillig, Marc

doi:10.1007/s004310050652

Cited by 36 publications

(25 citation statements)

References 8 publications

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“…One group proposed a staged approach to management, consisting of stimulating fetal lung maturation before Caesarian section, then treating the neonate with classic therapy for heart failure and heart block [18]. The difficult decision of whether and when to perform Caesarian section may best be done on a case-by-case basis.…”

Section: Therapymentioning

confidence: 99%

Neonatal lupus: Clinical features, therapy, and pathogenesis

Lee

2001

Curr Rheumatol Rep

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Neonatal lupus is a disease characterized by one or more of the following findings: congenital heart block, cardiomyopathy, cutaneous lupus lesions, hepatobiliary disease, and thrombocytopenia. Accumulating evidence indicates that the disease is probably caused by maternal autoantibodies, particularly autoantibodies of the Ro family. While often initially asymptomatic, mothers tend to develop symptoms of connective tissue disease. This review discusses the recent advances in the understanding of neonatal lupus, its clinical features, therapy, and pathogenesis.

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Section: Therapymentioning

confidence: 99%

Neonatal lupus: Clinical features, therapy, and pathogenesis

Lee

2001

Curr Rheumatol Rep

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“…Deloof et al [6] reported two preterm babies with anasarca. Isoprenaline was the initial treatment, followed by a trans-oesophageal stimulation until the resolution of the anasarca.…”

Section: Discussionmentioning

confidence: 98%

Electro-stimulation in preterm neonates with congenital auriculo-ventricular block. Report of three cases

Rakza

Rifai

Delapintiere

et al. 2004

European Journal of Pediatrics

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“…However, the response to these medications is usually insignificant, as evidenced in our patient. (3) In view of this, temporary pacing via the transcutaneous, epicardial or transvenous route is often instituted until the infant is of sufficient size for the permanent insertion of an epicardial pacing system. The decision to initiate temporary pacing in the present case was the low birth weight of the child, which precluded insertion of a permanent pacemaker.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of a premature low-birth-weight neonate with congenital complete heart block for implantation of temporary epicardial pacing wires

Shahani²

2014

smedj

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C a s e R e p o r t e9 I NTRO D U C TIO NComplete congenital heart block (CCHB) is a rare condition with an incidence of 1 in 20,000 live births.(1) Neonates with CCHB often require surgery (and therefore anaesthesia) for the insertion of temporary or permanent electronic pacing wires.As this condition occurs infrequently, the most favourable method of induction and maintenance of anaesthesia is unclear, although several techniques have been used. We herein report the anaesthetic conduct of a low-birth-weight neonate who underwent temporary epicardial pacing wire insertion with good outcome. CA S E R EPO RTThe mother of our patient was a 24-year-old Malay woman with no prior known medical problem. She had previously undergone a full term pregnancy that culminated in a normal vaginal delivery of a healthy baby three years prior to the current presentation. During this current pregnancy, screening at 23 weeks of gestation demonstrated fetal heart block with an atrial rate of 130-140 bpm and a ventricular rate of 48-51 bpm.The mother was subsequently found to be positive for antiribonucleoprotein, anti-Ro, anti-La and antinuclear antibodies, but negative for anti-ds DNA, anti-Smith, anti-Scl-70 and anti-Jo-1 antibodies. She was diagnosed with Sjögren's syndrome, and was started on 8 mg dexamethasone once every morning and 4 mg salbutamol three times a day at 25 weeks of gestation in an attempt to increase the fetal heart rate.However, salbutamol was stopped a week later as the mother Anaesthetic management of a premature low-birthweight neonate with congenital complete heart block for implantation of temporary epicardial pacing wires ABSTRACT The optimal anaesthetic management of neonates with complete congenital heart block (CCHB) is unknown, as there is a low incidence of such cases. Neonates with CCHB often require surgery for the initiation of electronic pacing. In addition to the challenges of anaesthetising a neonate, this procedure is risky due to the potential for hypotension, arrhythmias and cardiac arrest. We herein present the case of a premature low-birth-weight neonate with antibody-related CCHB and normal heart structure who underwent anaesthesia and surgery for epicardial pacing wire insertion on Day 1 of life. We also compare our patient's anaesthetic conduct and outcome with similar previously reported cases.

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Management with a staged approach of the premature hydropic fetus due to complete congenital heart block

Abstract: This proposed staged approach with temporary epicardial leads can improve the outcome of hydropic fetuses due to complete congenital AV block.

Cited by 36 publications

References 8 publications

Neonatal lupus: Clinical features, therapy, and pathogenesis

Neonatal lupus: Clinical features, therapy, and pathogenesis

Electro-stimulation in preterm neonates with congenital auriculo-ventricular block. Report of three cases

Anaesthetic management of a premature low-birth-weight neonate with congenital complete heart block for implantation of temporary epicardial pacing wires

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