{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:28:11Z","timestamp":1740126491225,"version":"3.37.3"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T00:00:00Z","timestamp":1511222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>The study was conducted to determine an effective method for identifying patients at high risk of developing isolated complete atrioventricular block (CAVB<\/jats:styled-content>) and to review the efficacy of prenatal anti\u2010inflammatory treatment.<\/jats:p><\/jats:sec>Methods<\/jats:title>Fourteen CAVB<\/jats:styled-content> cases and 76 anti\u2010R<\/jats:styled-content>o\u2010positive cases without CAVB<\/jats:styled-content> were included in the study. Anti\u2010R<\/jats:styled-content>o\/L<\/jats:styled-content>a titers by double immunodiffusion and the prevalence of anti\u201052\u2009kD<\/jats:styled-content>a\/60\u2009kD<\/jats:styled-content>a\u2010R<\/jats:styled-content>o\/48\u2009kD<\/jats:styled-content>a\u2010L<\/jats:styled-content>a by Western blotting were compared between anti\u2010R<\/jats:styled-content>o\u2010positive women with and without CAVB<\/jats:styled-content>. Outcomes of anti\u2010R<\/jats:styled-content>o\u2010positive CAVB<\/jats:styled-content> cases were compared based on active prenatal anti\u2010inflammatory treatment (plasma exchange or transplacental betamethasone). We evaluated the outcomes of five pregnancies from three women who had an affected child and underwent prophylactic plasma exchange (PEX) during subsequent pregnancy.<\/jats:p><\/jats:sec>Results<\/jats:title>Ten out of 14 patients with CAVB<\/jats:styled-content> were positive for anti\u2010R<\/jats:styled-content>o. Anti\u2010R<\/jats:styled-content>o titers were significantly higher in patients with CAVB<\/jats:styled-content> (CAVB<\/jats:styled-content> median 64; without CAVB<\/jats:styled-content> median 16; P<\/jats:italic><\/jats:styled-content>\u2009<\u20090.01). All cases with CAVB<\/jats:styled-content> showed high titers of anti\u2010R<\/jats:styled-content>o (\u2265 32\u00d7), whereas only 42% of cases without CAVB<\/jats:styled-content> showed high titers (\u2265 32\u00d7) (P<\/jats:italic><\/jats:styled-content>\u2009<\u20090.001). The survival rate at one\u2009year was 80% in anti\u2010R<\/jats:styled-content>o\u2010positive CAVB<\/jats:styled-content> cases with active prenatal anti\u2010inflammatory treatment, but only 40% in cases that did not receive treatment. Recurrence was not observed in cases treated with prophylactic PEX.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>An anti\u2010R<\/jats:styled-content>o level of 32\u00d7 could be the threshold value for CAVB<\/jats:styled-content> development. Prenatal anti\u2010inflammatory treatment in patients with CAVB<\/jats:styled-content> and prophylactic PEX in patients who had an affected child may have the potential to improve pregnancy outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13511","type":"journal-article","created":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T06:56:46Z","timestamp":1511247406000},"page":"228-233","source":"Crossref","is-referenced-by-count":1,"title":["Predictive markers and prenatal management of isolated fetal complete atrioventricular block: A<\/scp> retrospective review at a single institution"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2844-620X","authenticated-orcid":false,"given":"Keisuke","family":"Murakami","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine Tokyo 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Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Makino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4554-164X","authenticated-orcid":false,"given":"Atsuo","family":"Itakura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Juntendo University Faculty of Medicine Tokyo 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