CCHC, clinical chemistry, hepatocellular injury; CCHB
, clinical chemistry, hepatobiliary injury; MFHC, morphological finding, hepatocellular injury; MFHB, morphological finding, hepatobiliary injury.
For fetuses with CCHB, Biophysical profile (BPP) score alone is not a good indicator of fetal wellbeing.
Cutaneous, hepatic and hematological manifestations of NLE resolve without any long term sequelae and proper management of CCHB with pacemaker implantation determines the long term prognosis.
(1.) Michaelsson M, Engle MA CCHB: An international study of the natural history.
ABBREVIATIONS: CCHB: Complete congenital heart block.
Diagnosing CCHB in a fetus can be difficult and requires careful echocardiographic analysis (usually performed at about 20 weeks gestation).
Once the diagnosis is made, it is important to determine the etiology for the CCHB. For women carrying anti-Ro and anti-La antibodies, there is a 2% risk of fetal heart block during pregnancy.
The mechanism for CCHB in patients exposed to maternal antibodies is transplacental autoimmune injury to the fetal atrioventricular node, where Ro and La antigens abound.