Case Report: A multidisciplinary, protocol-driven pathway from recurrent pregnancy loss to live birth in an anti-Ro/SSA-positive primary Sjögren’s syndrome pregnancy with literature review

In an anti-Ro/SSA-positive pregnancy at extreme risk, a prevention-first, protocol-driven approach-centered on hydroxychloroquine, judicious immunomodulation, and structured AV-interval surveillance-successfully averted CAVB and resulted in a pacemaker-free live birth. Minor cardiac lesions warrant ongoing follow-up; however, the absence of conduction disease underscores the clinical utility of this strategy in carefully selected, extreme-risk pregnancies.