OP11.11: Spectrum of disorders of fetal cardiac rate and rhythm in anti‐Rho‐positive mothers: a single centre experience over one year

Anti-Rho antibodies in the maternal circulation are known to cross the placenta and affect the fetal cardiac conduction system causing scarring resulting in irreversible complete congenital heart block (CHB) in 2-3% of untreated cases. Antenatal management of these cases by various strategies of monitoring, prophylaxis and therapy is a matter of intense research in Maternal Fetal Medicine. We share our experience of 9 cases, of mothers who were anti Rho positive with respect to cardiac manifestations in the fetus and their management over the period of an year. Mothers already diagnosed to have an autoimmune disorder; positive for anti-Rho antibodies were followed weekly between 16 to 26 weeks and fortnightly thereafter with PR interval. Those who presented with abnormalities of fetal heart and subsequently found to be positive for anti-Rho were monitored for development of hydrops on weekly basis. Prophylaxis: Mothers known to have SLE; on HCQ; but no history of prior baby with CHB 3 cases. Continued HCQ throughout current gestation for maternal indications. None developed CHB. Overall eight babies, aged 1-9 months have survived, one with pacemaker, and rest without it, till the time of this submission. Multidisciplinary care involving maternal fetal medicine experts, paediatric cardiologists, neonatologists, rheumatologists and obstetricians, can help achieve fair neonatal survival rates for this challenging disorder.