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    Prenatal heart block screening in mothers with SSA/SSB autoantibodies: Targeted screening protocol is a cost‐effective strategy

    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… More >

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