S Sayama1, N Takeda2, T Iriyama1, R Inuzuka3, S Maemura2, D Fujita2, H Yamauchi4, K Nawata4, M Bougaki5, H Hyodo6, R Shitara1, T Nakayama1, A Komatsu1, T Nagamatsu1, Y Osuga1, T Fujii1. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan. 2. Department of Cardiovascular Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan. 3. Department of Pediatrics, Faculty of Medicine, University of Tokyo, Tokyo, Japan. 4. Department of Cardiovascular Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan. 5. Department of Anesthesiology and Pain Relief Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan. 6. Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Abstract
OBJECTIVE: To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN: Retrospective case series study. SETTING: Tertiary perinatal care centre at a university hospital. POPULATION: Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute. METHODS: The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records. MAIN OUTCOME MEASURES: Obstetrical management and complication including the incidence of AD throughout the peripartum period. RESULTS: Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test). CONCLUSIONS: Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm. TWEETABLE ABSTRACT: MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.
OBJECTIVE: To investigate pregnancy outcomes, especially the risk of pregnancy-related aortic dissection (AD), in patients with Marfan syndrome (MFS) after prophylactic aortic root replacement (ARR). DESIGN: Retrospective case series study. SETTING: Tertiary perinatal care centre at a university hospital. POPULATION: Pregnant women fulfilling the revised Ghent nosology (2010) criteria for MFS who were managed at our institute. METHODS: The pregnancy outcomes of all patients with MFS managed at our institute between 1982 and September 2016 were reviewed retrospectively based on medical records. MAIN OUTCOME MEASURES: Obstetrical management and complication including the incidence of AD throughout the peripartum period. RESULTS: Among 22 patients (28 pregnancies) who had been managed as potential MFS or related disorders, 14 (17 pregnancies) fulfilled the revised Ghent nosology (2010) criteria for MFS and were enrolled in this study. Five patients (five pregnancies) had received ARR before conception: three (60%) developed type B aortic dissection [AD(B)] during the peripartum period, compared with only one of 10 patients (12 pregnancies) without ARR (P < 0.05, Chi-square test). CONCLUSIONS: Our study results suggest that MFS patients after prophylactic ARR are still at high risk of AD(B) during the peripartum period. Careful pre-pregnancy counselling and multidisciplinary care throughout the peripartum period are essential for the management of MFS, even after surgical repair of an ascending aortic aneurysm. TWEETABLE ABSTRACT: MFS patients after prophylactic ARR are still at high risk of type B aortic dissection during the peripartum period.
Authors: Jennifer Pardo Habashi; Elena Gallo MacFarlane; Rustam Bagirzadeh; Caitlin Bowen; Nicholas Huso; Yichun Chen; Djahida Bedja; Tyler J Creamer; Graham Rykiel; Maurice Manning; David Huso; Harry C Dietz Journal: Sci Transl Med Date: 2019-05-01 Impact factor: 17.956
Authors: Anish Keepanasseril; N Thendral; Gowri Dorairajan; Murali Subbaih; Ajith Ananthakrishna Pillai; B V Sai Chandran Journal: Obstet Med Date: 2018-07-20
Authors: Laurence Campens; Lucia Baris; Nandita S Scott; Craig S Broberg; Antione Bondue; Guillaume Jondeau; Jasmine Grewal; Mark R Johnson; Roger Hall; Julie De Backer; Jolien W Roos-Hesselink Journal: Heart Date: 2021-01-19 Impact factor: 5.994