Medicine Matters rheumatology

A is the correct answer. Anti-Ro/SSA and/or anti-La/SSB antibodies begin to actively cross the placenta after 16 weeks of gestation and may cause CHB, although it is a rare event in women with no previous neonates with CHB (0.7-2% of pregnancies exposed to these autoantibodies). There is evidence suggesting that hydroxychloroquine may reduce the odds for this complication. According to local protocols, women with anti-Ro/SSA and/or anti-La/SSB can be offered a surveillance protocol comprising weekly/biweekly fetal echocardiograms from 16–26 weeks of gestation to ensure timely diagnosis of CHB. However, it is unclear whether such an intensive surveillance during pregnancy is cost-effective, since no treatment seems to significantly improve fetal/neonatal morbidity or mortality.

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