Complete Heart Block and Pregnancy Outcome: An Analysis from Eastern India

at 1 in 15,000 to 20,000 live birth [2,3]. It can be completely idiopathic and can also be a result of passive autoimmunity with cardiac ailment in response to active transport of maternal IgG autoantibodies to fetal circulation, as in SLE. The history of CHB begins in utero and there is a tendency for female preponderance [2-4]. One study group followed up 102 subjects with CHB during adulthood and observed in lifelong perspective and explained it to be a life threatening disease with significant morbidity and risk of Stokes Adams (SA) attacks and sudden death at any age could be anticipated even in the absence of poor prognostic signs [5]. Patients with isolated CHB, who survive infancy are usually asymptomatic and achieve normal growth and development although mortality in this period is 8% [2]. Thus cases associated with pregnancy may be observed. CHB is rare and relatively serious problem in pregnancy as feto-maternal outcome is concerned. A normal physiologic response to pregnancy creates an increased cardiac output by 30 to 50% by increased heart rate and blood volume. These alterations pose a substantial challenge in the setting of fixed maternal heart rate. As pregnancy and CHB is a rare association and reported in the literature as small series or isolated case reports, there are no established guidelines regarding management.