Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases

ObjectiveTo analyze the clinical characteristics, echocardiographic features, and prognosis of fetuses with maternal immune diseases.MethodsWe retrospectively evaluated 20 fetuses with cardiac manifestations due to maternal immune diseases from our center between 2019 and 2023 in China. Clinical and...

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Main Authors: Shaoli Yin, Qi Lin, Shaoting Huang, Jinfeng Xu, Yujuan Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1564873/full
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author Shaoli Yin
Qi Lin
Shaoting Huang
Jinfeng Xu
Yujuan Zhang
author_facet Shaoli Yin
Qi Lin
Shaoting Huang
Jinfeng Xu
Yujuan Zhang
author_sort Shaoli Yin
collection DOAJ
description ObjectiveTo analyze the clinical characteristics, echocardiographic features, and prognosis of fetuses with maternal immune diseases.MethodsWe retrospectively evaluated 20 fetuses with cardiac manifestations due to maternal immune diseases from our center between 2019 and 2023 in China. Clinical and echocardiographic data of fetuses and maternal sero-immunity were collected. The pregnancy outcomes were followed up.ResultsThe cardiac manifestations seen in 20 fetuses were categorized into three types: type I: isolated-arrhythmia: seven cases (35%); type II: isolated endocardial fibroelastosis (EFE): four cases (20%); and type III: both arrhythmia and EFE: nine cases (45%). The arrhythmias in all cases were bradyarrhythmia, including sinus bradycardia and atrioventricular block. The results of maternal antibody test showed the following three types: (1) five cases were positive for anti-SSA antibody alone; (2) 10 cases of positive for both anti-SSA and anti-SSB antibody; (3) five cases of other special types of antibodies. Ultimately, four newborns were delivered and 16 fetuses were terminated. Of the mothers who chose to induce labor, three were treated and repregnant, two of which had normal fetuses, while one had a recurrence of arrhythmia, which was treated and monitored closely during the prenatal period, resulting in normalization of the fetal heart rhythm and eventual full-term delivery.ConclusionFetal cardiac involvement due to maternal immune diseases can be categorized into three types: the isolated-arrhythmia, isolated EFE, and both arrhythmia and EFE. In our study, all cases of arrhythmia were bradyarrhythmias, with sinus bradycardia being the most prevalent type. Given the strong association between maternal autoimmune diseases and fetal cardiac abnormalities such as bradyarrhythmias and EFE, prenatal ultrasound findings of these conditions should raise suspicion for maternal immune disorders. Consequently, prompt screening for maternal autoimmune antibodies is recommended.
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spelling doaj-art-24abb70570dc49f2a6f7e3eada5a40eb2025-08-20T03:31:20ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15648731564873Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseasesShaoli YinQi LinShaoting HuangJinfeng XuYujuan ZhangObjectiveTo analyze the clinical characteristics, echocardiographic features, and prognosis of fetuses with maternal immune diseases.MethodsWe retrospectively evaluated 20 fetuses with cardiac manifestations due to maternal immune diseases from our center between 2019 and 2023 in China. Clinical and echocardiographic data of fetuses and maternal sero-immunity were collected. The pregnancy outcomes were followed up.ResultsThe cardiac manifestations seen in 20 fetuses were categorized into three types: type I: isolated-arrhythmia: seven cases (35%); type II: isolated endocardial fibroelastosis (EFE): four cases (20%); and type III: both arrhythmia and EFE: nine cases (45%). The arrhythmias in all cases were bradyarrhythmia, including sinus bradycardia and atrioventricular block. The results of maternal antibody test showed the following three types: (1) five cases were positive for anti-SSA antibody alone; (2) 10 cases of positive for both anti-SSA and anti-SSB antibody; (3) five cases of other special types of antibodies. Ultimately, four newborns were delivered and 16 fetuses were terminated. Of the mothers who chose to induce labor, three were treated and repregnant, two of which had normal fetuses, while one had a recurrence of arrhythmia, which was treated and monitored closely during the prenatal period, resulting in normalization of the fetal heart rhythm and eventual full-term delivery.ConclusionFetal cardiac involvement due to maternal immune diseases can be categorized into three types: the isolated-arrhythmia, isolated EFE, and both arrhythmia and EFE. In our study, all cases of arrhythmia were bradyarrhythmias, with sinus bradycardia being the most prevalent type. Given the strong association between maternal autoimmune diseases and fetal cardiac abnormalities such as bradyarrhythmias and EFE, prenatal ultrasound findings of these conditions should raise suspicion for maternal immune disorders. Consequently, prompt screening for maternal autoimmune antibodies is recommended.https://www.frontiersin.org/articles/10.3389/fmed.2025.1564873/fullfetusultrasoundmaternal immune diseasesarrhythmiaendocardial fibroelastosis
spellingShingle Shaoli Yin
Qi Lin
Shaoting Huang
Jinfeng Xu
Yujuan Zhang
Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
Frontiers in Medicine
fetus
ultrasound
maternal immune diseases
arrhythmia
endocardial fibroelastosis
title Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
title_full Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
title_fullStr Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
title_full_unstemmed Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
title_short Ultrasonographic characterization and prognostic follow-up of fetal cardiac involvement in maternal immune diseases
title_sort ultrasonographic characterization and prognostic follow up of fetal cardiac involvement in maternal immune diseases
topic fetus
ultrasound
maternal immune diseases
arrhythmia
endocardial fibroelastosis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1564873/full
work_keys_str_mv AT shaoliyin ultrasonographiccharacterizationandprognosticfollowupoffetalcardiacinvolvementinmaternalimmunediseases
AT qilin ultrasonographiccharacterizationandprognosticfollowupoffetalcardiacinvolvementinmaternalimmunediseases
AT shaotinghuang ultrasonographiccharacterizationandprognosticfollowupoffetalcardiacinvolvementinmaternalimmunediseases
AT jinfengxu ultrasonographiccharacterizationandprognosticfollowupoffetalcardiacinvolvementinmaternalimmunediseases
AT yujuanzhang ultrasonographiccharacterizationandprognosticfollowupoffetalcardiacinvolvementinmaternalimmunediseases