<prompt> A fetus was found to have congenital heart block what should be evaluated in the mother?Apla SyndromeCongenital heart defectsSLEHemolytic anemia  <response>: Ans. c SLERef- Williams Obstetrics 25th Ed; Page No-1139-42 Congenital heart block develops almost exclusively in fetuses of women with antibodies to the SS-A or SS-B antigens for Anti-Ro SS-A antibody. Prevalence rate with these antibodies are 30-49. Fetal cardiac monitoring is performed between 18 and 26 weeks gestation in pregnancies with either of these antibodies. Incidence of fetal myocarditis is only 2-3; if these antibodies are present.Extra MileAutoantibodies produced in patients with systemic lupus erythematosus SLEAntibodyClinical associationsPrevalenceAntihistoneCommon in drug-induced lupus70Anti-Ro SS-AAssociated with sicca syndrome, predisposes to cutaneous lupus, neonatal lupus with heart block, reduced risk of nephritis30-49Anti-La SS- BAssociated with anti-Ro10-35Anti-dsDNAMay correlate with disease activity, nephritis, and vasculitis Anti- RNPhigh titers associated with rheumatic syndromes33-40Antinuclear ANABest screening test, multiple antibodies; a second negative test makes SLE unlikely84-98Anti-Sm SmithSpecific for SLE25-38Antiphospho- lipidLupus anticoagulant and anticardiolipin anti bodies associated with thrombosis, fetal loss, thrombocytopenia, valvular heart disease; false positive test for syphilis21-50AntierythrocyteDirect Coo m b s test, may develop hemolysis60 