病例报告及文献复习。产前检测到的非免疫性房室传导阻滞和母体心律失常-病例介绍和文献复习

A. Michalak, M. Witczak, Elżbieta Kukawczyńska, Marek Niwald, M. Respondek-Liberska
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引用次数: 1

摘要

摘要:我们的临床报告描述了一个罕见的发现,产前发现先天性房室(AVB)传导阻滞,没有相关的母体抗体,从1 /2度AVB发展到妊娠后半期的完全心脏传导阻滞。第12周的产科超声未发现任何异常,第18周的产前超声心动图(由于家庭成员室间隔缺损)检测到1度传导阻滞,然后是重音和心动过缓。采用b -2模拟物经胎盘治疗。分娩在三级中心组织,新生儿的起搏器在生命的第15天被固定并植入。目前男孩情况良好,稳定。在使用b -2模拟物治疗前,母亲进行了超声心动图和心电图检查,发现临床无症状的心脏结构和传导异常。文献发现,非免疫性先天性或儿童期AVB患儿的父母比一般人群更容易携带临床沉默的传导异常。考虑到母亲和儿子的相应发现,他们应该是基因检测的好候选人。
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Case report and literature review. Prenatally Detected Non-Immune Atrioventricular Block and Maternal Arrhythmia - Case Presentation and Literature Review
Abstract Our clinical report describes a rare finding of a prenatally-detected congenital atrioventricular (AVB) block without associated maternal antibodies, which progressed from 1st/2nd degree AVB to complete heart block during second half of pregnancy. Obstetrical ultrasound at 12th week did not reveal any abnormalities and prenatal echocardiography (due to VSD in afamily member) at the 18th week of gestation detected 1st degree block, then bigeminy and bradycardia. Transplacental treatment with B-2-mimetics was introduced. The delivery was organized in a tertiary center and a pacemaker for the newborn baby was secured and implanted in 15th day of life. Currently the boy`s condition is good and stable. Before therapy with B-2-mimetics the mother underwent echocardiography and ECG which revealed clinically silent structural and conduction heart abnormalities. Literature findings suggest that parents of children with non-immune congenital or childhood AVB are more likely to carry clinically silent conduction abnormalities than general population. Given the corresponding findings in the mother and her son, they should be good candidates for genetic testing.
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