Third-degree block, no hydrops fetalis
Second-degree block or alternating
second/third-degree block
Prolonged mechanical PR interval
(first-degree block)
Block associated with signs of myocarditis, CHF and/or hydropic changes
Severely hydropic fetus |
Evaluation by serial echocardiography; no therapy.
Administer 4 mg of oral dexamethasone daily. If progression to third-degree block occurs, taper dexamethasone dosage to discontinuation. If reversal to NSR or lesser forms of block occurs, continue to delivery at term.
Repeat echocardiography in 24 h. If first-degree block persists, administer 4 mg of oral dexamethasone daily. If progression to third-degree block occurs, taper dexamethasone dosage to discontinuation. If reversal to NSR occurs or first-degree block persists, taper or individualize therapy.
Treatment with 4 mg of oral dexamethasone daily until improvement.
Consider termination. Treatment with 4 mg of oral dexamethasone
daily and apheresis to rapidly remove maternal antibodies. |
