A challenge in managing fetal congenital total avb with negative anti-ro and anti-la and positive anti nuclear antibody pregnant woman: A case report

Atrioventricular block (AVB) occurs in approximately one in 15,000 to 20,000 live births. Congenital complete AV block (AVB) may arise from various mechanisms, whether immune-mediated or otherwise. In the context of immune-mediated AV block, a variety of factors contribute to its development, often including the passage of maternal autoantibodies (anti-Ro/SSA and/or anti-La/SSB) across the placenta. Of all AVBs, 40% are predominantly linked to maternal antibodies positive for SSA/Ro or SSB/La. Through placental circulation, these antibodies may cause immune-mediated inflammation or fibrosis in fetal cardiac tissues, which is crucial for conduction. Presented here is a case of complete congenital atrioventricular block in the fetus, characterized by negative maternal Ro/SSA and La/SSB but positive in the Anti Nuclear Antibody test. The baby was delivered by cesarean section at term with Apgar scores of 7 and 8, and a temporary pacemaker was installed at one day old, leading to a favorable outcome.