Aortic complications in pregnancy: the less remembered chapter—a narrative review
Pregnancy increases the risk of common vascular events and also the rarer events like aortic dissection (AD)/aortic rupture and this is even more pronounced in patients with predisposing aortopathies. AD was found to occur in 0.0004% of all pregnancies, and it is more pronounced in patients with und...
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Open Exploration Publishing Inc.
2021
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oai:doaj.org-article:45f77c0b2c72427bb64f49c4ee72398c2021-11-08T09:39:56ZAortic complications in pregnancy: the less remembered chapter—a narrative review10.37349/emed.2021.000602692-3106https://doaj.org/article/45f77c0b2c72427bb64f49c4ee72398c2021-10-01T00:00:00Zhttps://www.explorationpub.com/Journals/em/Article/100160https://doaj.org/toc/2692-3106Pregnancy increases the risk of common vascular events and also the rarer events like aortic dissection (AD)/aortic rupture and this is even more pronounced in patients with predisposing aortopathies. AD was found to occur in 0.0004% of all pregnancies, and it is more pronounced in patients with underlying connective tissue disorders. The normal hemodynamic changes on a weak aorta will lead to AD and/or rupture, more so with increase in the period of gestation. Hence the haemodynamic and hormonal changes during pregnancy make pregnancy itself a risk factor for AD. It is advised that women with Marfan syndrome who are planning pregnancy should go through prophylactic aortic repair if the diameter of the ascending aorta exceeds 4 cm. Pre-pregnancy counselling is very important in these patients and must include complete history taking, including family history, physical examination and advanced aortic imaging. There is a general consensus among various authors advising against surgery during pregnancy in stable patients due to increased maternal and fetal morbidity but it is justified if the condition is refractory to medical management or in life threatening stage like acute AD. Though the incidence of aortopathy in pregnancy is rare, there is a high maternal and fetal mortality associated with this condition.Preetha RajasekaranPraveena GandhiMohammed IdhreesBashi V. VelayudhanOpen Exploration Publishing Inc.articleaortaaortic dissectionpregnancycongenital heart diseasemarfan syndromeehlers–danlos syndromecardiopulmonary bypassOther systems of medicineRZ201-999ENExploration of Medicine, Vol 2, Iss 5, Pp 423-434 (2021) |
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aorta aortic dissection pregnancy congenital heart disease marfan syndrome ehlers–danlos syndrome cardiopulmonary bypass Other systems of medicine RZ201-999 |
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aorta aortic dissection pregnancy congenital heart disease marfan syndrome ehlers–danlos syndrome cardiopulmonary bypass Other systems of medicine RZ201-999 Preetha Rajasekaran Praveena Gandhi Mohammed Idhrees Bashi V. Velayudhan Aortic complications in pregnancy: the less remembered chapter—a narrative review |
description |
Pregnancy increases the risk of common vascular events and also the rarer events like aortic dissection (AD)/aortic rupture and this is even more pronounced in patients with predisposing aortopathies. AD was found to occur in 0.0004% of all pregnancies, and it is more pronounced in patients with underlying connective tissue disorders. The normal hemodynamic changes on a weak aorta will lead to AD and/or rupture, more so with increase in the period of gestation. Hence the haemodynamic and hormonal changes during pregnancy make pregnancy itself a risk factor for AD. It is advised that women with Marfan syndrome who are planning pregnancy should go through prophylactic aortic repair if the diameter of the ascending aorta exceeds 4 cm. Pre-pregnancy counselling is very important in these patients and must include complete history taking, including family history, physical examination and advanced aortic imaging. There is a general consensus among various authors advising against surgery during pregnancy in stable patients due to increased maternal and fetal morbidity but it is justified if the condition is refractory to medical management or in life threatening stage like acute AD. Though the incidence of aortopathy in pregnancy is rare, there is a high maternal and fetal mortality associated with this condition. |
format |
article |
author |
Preetha Rajasekaran Praveena Gandhi Mohammed Idhrees Bashi V. Velayudhan |
author_facet |
Preetha Rajasekaran Praveena Gandhi Mohammed Idhrees Bashi V. Velayudhan |
author_sort |
Preetha Rajasekaran |
title |
Aortic complications in pregnancy: the less remembered chapter—a narrative review |
title_short |
Aortic complications in pregnancy: the less remembered chapter—a narrative review |
title_full |
Aortic complications in pregnancy: the less remembered chapter—a narrative review |
title_fullStr |
Aortic complications in pregnancy: the less remembered chapter—a narrative review |
title_full_unstemmed |
Aortic complications in pregnancy: the less remembered chapter—a narrative review |
title_sort |
aortic complications in pregnancy: the less remembered chapter—a narrative review |
publisher |
Open Exploration Publishing Inc. |
publishDate |
2021 |
url |
https://doaj.org/article/45f77c0b2c72427bb64f49c4ee72398c |
work_keys_str_mv |
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