A 4 hours old age neonatal male with 37 weeks gestational age which admitted to neonatal intensive care unit (NICU) because of bradycardia (60-70 beats/ minute) and respiratory distress . His mother was 22 years old (Gravid 2, Para 1, Abortion 0) with normal examination and vital signs and pervious normal delivery. In 29 weeks gestational age she was reported to our emergency department because of fetus bradycardia (70-80 beats/ minute) in routine abdominal sonographic study. Ultrasound revealed no evidence of fetal distress. Fetal echocardiography showed complete heart block without any structural heart damage (isolated congenital heart block). She had no symptom of any autoimmune disease but immunological tests showed positive SS-A (Ro) antibodies (anti- Ro titer: 37.5).
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She was advised to receive dexamethasone and iron supplementation but she did not accept any medication such as IVIG or corticoestroid. She was followed up by weekly ultrasound to follow the FHR pattern and FHR was stable at 60-65 beats/ minute with no features of hydrops .At 37 weeks gestational age she underwent a caesarean section(C/S) due to preeclampsia. The heart rate at birth was 65 beats / minute (Figures 1). Post-delivery at NICU, the newborn was intubated duo to respiratory distress and extubated after about 48 hours and got stable with heart rate of 65 beats / minute. Biochemical tests and atrial blood gas (ABG) evaluation were in normal range. Echocardiography did not reveal any Cardiac structural abnormalities such as congenitally corrected transposition of the great arteries (CCTGA), Ebstein anomaly, left isomerism with the heart defect and left ventricular non-compact (LVNC). Left ventricular size and systolic function were normal. The neonate did not have heart
She was advised to receive dexamethasone and iron supplementation but she did not accept any medication such as IVIG or corticoestroid. She was followed up by weekly ultrasound to follow the FHR pattern and FHR was stable at 60-65 beats/ minute with no features of hydrops .At 37 weeks gestational age she underwent a caesarean section(C/S) due to preeclampsia. The heart rate at birth was 65 beats / minute (Figures 1). Post-delivery at NICU, the newborn was intubated duo to respiratory distress and extubated after about 48 hours and got stable with heart rate of 65 beats / minute. Biochemical tests and atrial blood gas (ABG) evaluation were in normal range. Echocardiography did not reveal any Cardiac structural abnormalities such as congenitally corrected transposition of the great arteries (CCTGA), Ebstein anomaly, left isomerism with the heart defect and left ventricular non-compact (LVNC). Left ventricular size and systolic function were normal. The neonate did not have heart