Fetal Arrhythmia with a Myriad of Complications

A 22-year-old primigravida with hypothyroidism gave birth to a neonate with congenital complete heart block, likely due to maternal Sjogren syndrome. The neonate, born at 39 weeks, exhibited severe bradycardia, hemodynamic instability, and dilated cardiomyopathy, requiring emergency interventions including temporary and permanent pacemaker implantation. Despite these efforts, the neonate died suddenly, with potential causes including electrolyte disturbances or pacemaker malfunction. The case highlights the importance of antenatal diagnosis and management of congenital heart block, especially in mothers with autoimmune conditions, as early intervention can significantly impact neonatal outcomes.