Patrick D. Evers1,*, Tarek Alsaied1,2,*, Jeffrey B. Anderson1, James F. Cnota1, Allison A. Divanovic1
Congenital Heart Disease, Vol.14, No.2, pp. 221-229, 2019, DOI:10.1111/chd.12713
Abstract Objective: Maternal anti-Ro/SSA and anti-La/SSB antibodies can lead to fetal complete heart block (CHB). Current guidelines recommend weekly echocardiographic
screening between 16 and 28 weeks gestation. Given the cost of screening and the
rarity of conduction abnormalities in fetuses of mothers with low anti-Ro levels
(<50 U/mL), we sought to identify a strategy that optimizes resource utilization.
Design: Decision analysis cost-utility modeling was performed for three screening
paradigms: “standard screening” (SS) in which mid-gestation mothers are screened
weekly, “limited screening” (LS) in which fetal echocardiograms are avoided unless
the fetus develops bradycardia, and “targeted screening by maternal antibody level”
(TS)… More >
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