Coordinated Multidisciplinary Care Enables Safe Vaginal Delivery in Complete Heart Block: A Case Report

Congenital atrioventricular block (CAVB) is a rare condition that presents unique challenges in pregnancy, especially in patients with permanent pacemaker implantation. Management requires careful coordination to ensure maternal and fetal safety. We report the case of a 35-year-old primigravida with isolated CAVB and a dual-chamber pacemaker (DDD mode), implanted for complete heart block. Pre-pregnancy cardiac evaluation revealed stable ventricular pacing with normal left ventricular function. A multidisciplinary team, including maternal-fetal medicine, cardiology, and electrophysiology, oversaw prenatal care. No changes in pacemaker settings were required during pregnancy or delivery. Labor was electively induced at 39 weeks due to a favorable cervical status and to ensure the availability of specialized staff. Continuous electronic fetal monitoring was employed during labor. Vaginal delivery was achieved without complications, resulting in the birth of a healthy neonate. No maternal or neonatal adverse events occurred in the peripartum period. This case illustrates that with coordinated interdisciplinary care and individualized labor planning, pregnancy and vaginal delivery can be safely achieved in women with CAVB and permanent pacemakers.