Prenatal Evaluation and Management of Fetuses Exposed to Anti-SSA/Ro Antibodies

REVIEW ARTICLE
Pediatr Cardiol (2012) 33:1245–1252

Prenatal Evaluation and Management of Fetuses Exposed
to Anti-SSA/Ro Antibodies
Anita Krishnan Jodi I. Pike Mary T. Donofrio

Received: 23 February 2012 / Accepted: 29 April 2012 / Published online: 22 May 2012
Springer Science+Business Media, LLC 2012
Abstract
Maternal anti-SSA antibodies are common, existing in up to 2 % of the general population. Fetuses
exposed to these antibodies are at risk for both cardiac and noncardiac complications. The cardiac complications
include arrhythmias, structural disease, and cardiomyopathy. Although rare, the cardiac disease associated with these
antibodies is permanent and severe. Current fetal echocardiographic screening tools are nonspecific. The type and
frequency of screening needed is controversial. Although promising transplacental treatment strategies exist, pro-
spective randomized studies are lacking. Dexamethasone, the medication used most frequently, imposes significant
risks to both mother and fetus. This report presents a discussion of the at-risk population, the spectrum of fetal
cardiac disease associated with maternal anti-SSA antibodies, the current fetal echocardiographic screening tools,
the therapeutic options, and the management and delivery planning strategies. With appropriate prenatal follow-up,
assessment, and delivery planning, even high-risk fetuses can be delivered safely and managed effectively.

Pediatr Cardiol (2012) 33:1245–1252