Effects of maternal anti-Ro/La antibodies on fetal atrioventricular conduction evaluated with echocardiography: a state-of-the-art review.

Anti-Ro/SSA and La/SSB antibodies can cross the placenta, affecting fetal cardiac development and leading to congenital heart block (CHB), a condition characterized by rapid progression, high mortality, and poor prognosis, emphasizing the importance of timely diagnosis and treatment. Fetal echocardiography is a critical diagnostic tool for CHB. With advancements in medicine and shifting health perspectives, the incidence, diagnostic approaches, and treatment methods for CHB are evolving. This review examines the impact of maternal antibodies on offspring, including their pathogenic mechanisms and other influencing factors such as antibody levels and maternal conditions. It also evaluates the application of fetal echocardiography in diagnosing CHB, covering techniques like M-mode, tissue Doppler, and spectral Doppler, and investigates antibody-associated CHB incidence. In addition, the review discusses management strategies for anti-Ro/SSA and anti-La/SSB positive pregnancies, including fetal in-utero treatment, preventive therapy for mothers, and other pharmacologic interventions. The findings highlight that antibody-related CHB is multifactorial, necessitating comprehensive consideration of influencing factors, prenatal counseling, and preventive medication management.