9. In Women With Systemic Lupus Erythematosus, How Is the Follow-up During Pregnancy and Immediate Puerperium Carried out?
10. In Foetus of Women Containing Positive Anti-Ro and/or Anti-La Antibodies, What Are the Most Effective Prevention and Treatment Options for the Management of Congenital Heart Block?
Cardiac neonatal lupus risk in children of mothers with anti-Ro Pifithrin is 2% and with anti-La antibodies is 5%53, 54 and 55 [LOE IIb]. CHB recurrence rate associated to anti-Ro antibodies is 17%56 [LOE IIb]. Neonatal cardiac lupus mortality rate is around 20%53 and 57 [LOE III]. In pregnant women with positive anti-Ro and/or anti-La antibodies, a foetal echocardiography must be performed weekly from week 16 to week 26 of gestation14, 52 and 58 [GR D].
A multicentre, open, with no randomized selection study did not show any benefits derived from the use of dexametasone to revert third degree CHB or the lack of progression from second to third degree CHB59 [LOE IIb]. A retrospective, multinational, multicentre study in 175 patients did not find significant differences in survival of foetus treated or not with fluorinated glucocorticoids, regardless of the dose, CHB degree and/or presence of anti-RO antibodies60 [LOE III]. The use of fluorinated glucocorticoids is not recommended in foetus with third degree CHB59 and 60 [GR C].
10. In Foetus of Women Containing Positive Anti-Ro and/or Anti-La Antibodies, What Are the Most Effective Prevention and Treatment Options for the Management of Congenital Heart Block?
Cardiac neonatal lupus risk in children of mothers with anti-Ro Pifithrin is 2% and with anti-La antibodies is 5%53, 54 and 55 [LOE IIb]. CHB recurrence rate associated to anti-Ro antibodies is 17%56 [LOE IIb]. Neonatal cardiac lupus mortality rate is around 20%53 and 57 [LOE III]. In pregnant women with positive anti-Ro and/or anti-La antibodies, a foetal echocardiography must be performed weekly from week 16 to week 26 of gestation14, 52 and 58 [GR D].
A multicentre, open, with no randomized selection study did not show any benefits derived from the use of dexametasone to revert third degree CHB or the lack of progression from second to third degree CHB59 [LOE IIb]. A retrospective, multinational, multicentre study in 175 patients did not find significant differences in survival of foetus treated or not with fluorinated glucocorticoids, regardless of the dose, CHB degree and/or presence of anti-RO antibodies60 [LOE III]. The use of fluorinated glucocorticoids is not recommended in foetus with third degree CHB59 and 60 [GR C].