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Macrosomia
8%
7/88
Neonatal hypoglycemia
5%
4/88
Heart block
48%
42/88
Pulmonary hypertension
15%
13/88
Meconium aspiration
20%
18/88
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This patient presents with vaginal dryness, eye irritation, dry mouth, and parotid gland enlargement, suggestive of Sjögren’s syndrome. Pregnant women with Sjögren’s syndrome are at greater risk of fetal heart block. Sjögren’s syndrome is an autoimmune disease characterized by destruction of the moisture-producing glands of the body leading to dry eyes, dry mouth, and vaginal dryness. The exact cause is unknown, but some combination of genetic and environmental factors are thought to be at play. Infants of women with Sjögren's are at risk for perinatal complications, as circulating anti-Ro(SSA) and anti-La (SSB) autoantibodies can cross the placenta and result in heart block. A pacemaker may be required for the affected infant. Incorrect Answers: Answer 1: Macrosomia is defined as birth weight > 4000g and is more common in post-term pregnancies and in infants of mothers with poorly controlled diabetes. Answer 2: Neonatal hypoglycemia can be seen in infants born to diabetic mothers due to beta-cell hyperplasia. Answer 4: Persistent pulmonary hypertension of the newborn may be seen as an idiopathic disease or in association with hypoplasia of the pulmonary vascular bed (especially in the setting of congenital diaphragmatic hernia). Answer 5: Meconium aspiration is more frequently seen in post-term pregnancies and typically presents with fetal respiratory distress, and dark, meconium-stained, amniotic fluid. Bullet Summary: Circulating anti-Ro (SSA) and anti-La (SSB) antibodies in pregnant women with Sjögren’s syndrome can cause fetal heart block.
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