Primary Sjogren's syndrome - Treatment of fetal incomplete atrioventricular block with dexamethasone

Pregnancies in women with autoantibodies against Ro/SSA and/or La/SSB may b e associated with permanent and treatment resistant fetal atrioventricular (AV) block. We describe a patient with primary Sjogren's syndrome and anti- Re (60 kDa and 52 kDa) and anti-La autoantibodies, in whom fetal bradycardi a with second-degree AV block was detected at 19 + 0 weeks of gestation. Ma ternal treatment with dexamethasone (4 mg/day po) was started 2 days later. The baby's heart rate improved gradually, returning to normal after about 6 weeks of treatment. Our case illustrates the importance of close monitori ng of the fetal heart rate in risk-pregnancies from about week 16 of gestat ion and initiation of dexamethasone treatment without delay when a block is detected.