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Posted On : 06 Jan 2014

my wife is pregnant 13 weeks , she was diagnosed sjogrens during fisrt delivery my first child 5yrs has complete heart block doing well without pacemaker , is there any treatment to prevent heart block antenatally. she is anti LA positive and asymptomatic.

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An association between congenital heart block {CHB} and connective tissue diseases such as lupus and Sjögren Syndrome has been reported in the literature. There is a strong correlation between congenital heart block and maternal autoantibodies to 48 kD La, 52 kD Ro and 60 kD Ro ribonucleoproteins. The underlying mechanism behind congenital heart block in Sjögren Syndrome is suggested to be due to Ro and La antigens present on apoptotic blebs on surface of actively remodelling foetal cardiocytes. The evidence to support prophylactic treatment to prevent congenital heart block during subsequent pregnancies is weak, and concerns regarding the safety of fluorinated steroids have been raised, particularly neurological toxicity, spontaneous abortion, stillbirths and intrauterine growth restriction. Other interventions, such as intravenous immunoglobulins, plasmapeheresis and Azathioprine have been suggested . You need to consult a pediatric cardiologist for the same.

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