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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Autores principales: Preetha Rajasekaran, Praveena Gandhi, Mohammed Idhrees, Bashi V. Velayudhan
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Lenguaje:EN
Publicado: Open Exploration Publishing Inc. 2021
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Acceso en línea:https://doaj.org/article/45f77c0b2c72427bb64f49c4ee72398c
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spelling 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)
institution DOAJ
collection DOAJ
language EN
topic aorta
aortic dissection
pregnancy
congenital heart disease
marfan syndrome
ehlers–danlos syndrome
cardiopulmonary bypass
Other systems of medicine
RZ201-999
spellingShingle 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
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AT praveenagandhi aorticcomplicationsinpregnancythelessrememberedchapteranarrativereview
AT mohammedidhrees aorticcomplicationsinpregnancythelessrememberedchapteranarrativereview
AT bashivvelayudhan aorticcomplicationsinpregnancythelessrememberedchapteranarrativereview
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