Matsushita H, Higashino M, Sekizuka N, Kurabayashi T, Takakuwa K, Tanaka K
Department of Obstetrics and Gynecology, Niigata University School of Medicine, 1-757 Asahimachi-dori, Niigata-city, Niigata 951-8510, Japan.
Arch Gynecol Obstet. 2002 Nov;267(1):51-3. doi: 10.1007/s004040100241.
Congenital heart block (CHB) is rather rare, and a poorer prognosis has been documented in fetuses with a ventricular rate <55 beats per minutes (bpm), in which therapeutic interventions during pregnancy have been warranted. We present a case of CHB associated with maternal anti-SSA/Ro antibody, diagnosed at 28 weeks' gestation. Fetal echocardiography revealed atrioventricular dissociation, with an atrial rate of 170 bpm and a ventricular rate of 54 bpm. To increase the fetal heart rate, maternal intravenous ritodrine infusion was undertaken, fetal ventricular rate was rapidly increased to 65 bpm. The pregnancy successfully continued until term, and a female infant weighing 2919 g was delivered by cesarean section with Apgar scores of 8 and 8 and 1 and 5 min. The infant is now 12 months of age and growing normally on oral terbutaline without pacing. In a case of fetal heart block, maternal administration of ritodrine may be a therapeutic intervention to improve the fetal and neonatal prognosis.
先天性心脏传导阻滞（CHB）相当罕见，有文献记载，心室率<55次/分钟（bpm）的胎儿预后较差，对此类胎儿在孕期有必要进行治疗干预。我们报告一例在孕28周时诊断为与母亲抗SSA/Ro抗体相关的CHB病例。胎儿超声心动图显示房室分离，心房率为170 bpm，心室率为54 bpm。为提高胎儿心率，对母亲进行了静脉输注利托君治疗，胎儿心室率迅速升至65 bpm。妊娠顺利持续至足月，通过剖宫产分娩出一名体重2919 g的女婴，其1分钟和5分钟Apgar评分分别为8分和8分、1分和5分。该婴儿现12个月大，口服特布他林后生长正常，未进行起搏治疗。对于胎儿心脏传导阻滞病例，母亲使用利托君可能是一种改善胎儿及新生儿预后的治疗干预措施。
