Complete congenital heart block in a neonate with a complex congenital heart defect in Africa

Complete congenital heart block (CHB) is a rare disorder. It has been estimated to occur in 20,000 live births (1). Isolated CHB frequently results from neonatal lupus erythematosus, a disease associated with transplacental passage of maternal anti-Ro/SSA and/or anti-La/SSB antibodies to the fetus (2). More rarely, it may be associated with a congenital structural heart defect (3). Although it is an uncommon disorder, CHB may be associated with a high morbidity and mortality. CHBs associated with severe structural heart disease have a poorer prognosis than infants with isolated CHB (4). As a result, it requires a high index of suspicion when there is a finding of fetal bradycardia for early diagnosis and appropriate planning of perinatal management in centers with facility for pacemaker treatment but this not often possible in low resource settings. Few cases of CHB associated with structural heart defects have been reported in Sub-Saharan Africa (SSA). One of the first cases of CHB in Africa was reported by Okoroma et al. in Nigeria in a 3-month-old infant who was successfully treated with pacemaker implantation (5)