Rainbow Children’s Heart Institute, Hyderabad, has achieved one of the world’s first successful clinical outcomes using direct fetal immunotherapy to treat immune-mediated fetal myocarditis, a rare and life-threatening heart condition affecting unborn babies.
The breakthrough has been published in JACC: Case Reports, placing the institute among a very small number of centres globally to demonstrate success with this advanced in-utero treatment. The study reports improved heart function and survival in all five foetuses treated between 21 and 27 weeks of gestation.
A High-Risk Case with Limited Options
The reported case involved a 29-year-old expectant mother diagnosed with Sjögren’s syndrome, an autoimmune condition. She had a history of previous fetal loss. At 22 weeks of pregnancy, fetal echocardiography revealed immune-mediated cardiomyopathy with second-degree heart block.
Maternal antibodies had crossed the placenta and damaged the developing fetal heart. As a result, the fetus showed a dangerously low heart rate and weak heart pumping, placing it at high risk of heart failure or fetal loss if untreated.
Direct Fetal Immunotherapy Changes the Outcome
Given the rapid progression of the disease, the multidisciplinary team at Rainbow opted for direct fetal immunotherapy, delivering treatment directly to the fetus under advanced imaging guidance. This approach was chosen because conventional maternal treatment may not reach the fetus quickly or in sufficient concentration in critical cases.
Following the intervention, fetal heart function improved significantly. The heart rate normalised to 150 beats per minute, and cardiac pumping recovered. The baby was later delivered at term with a normal heart rhythm and remained clinically stable after birth.
Expert Insights from the Treating Team
Dr Shweta Bakhru, Paediatric Cardiologist, said immune-mediated fetal heart disease often progresses rapidly and may go unnoticed.
“Direct fetal immunotherapy allows us to intervene at a critical stage and target the disease more effectively, potentially changing the baby’s outcome,” she explained.
Dr Bhargavi Dhulipudi emphasised that the procedure is reserved for severe and carefully selected cases.
“This is not routine treatment. It requires advanced imaging, precision, and close monitoring, but in the right cases, it offers a vital option where alternatives are limited,” she said.
Senior Paediatric Cardiologist Dr Nageswara Rao Koneti highlighted the global significance of the achievement.
“This success places our centre among a small group worldwide capable of managing severe immune-related fetal heart disease with targeted in-utero therapy,” he noted.
About Rainbow Children’s Heart Institute
Rainbow Children’s Hospitals is a leading name in women’s and paediatric healthcare in India. The Rainbow Children’s Heart Institute is a dedicated cardiac centre providing comprehensive care for children with congenital and acquired heart conditions, supported by a highly experienced team of specialists.
