[Multidisciplinary management of aortic dissection complicating pregnancy].
BACKGROUND
Most cases of aortic dissection observed in women under 40 years of age occur as a complication of pregnancy in patients with other risk factors. Case report. We report a case of dissection of the ascending aorta in a young primigravida at 35 weeks gestation. The risk factor was aortic regurgitation. Multidisciplinary management enabled fetal extraction followed by repair of the aorta. Outcome was favorable for both mother and child.


CONCLUSIONS
A review of the literature shows a variety of etiological factors leading to this disease. Emergency diagnosis and management is mandatory. Obstetricians should be aware that pregnancy can be a triggering factor in patients with a predisposition, e.g. connective tissue disease. A complete cardiovascular evaluation should be conducted before conception and a suitable surveillance planned for the entire pregnancy. The aim of this careful follow-up it to avoid surgery in an emergency setting that could compromise prognosis for both mother and child.
Haberstich
R
R
Service de Gynécologie-Obstétrique, Hôpital Civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg Cedex.
Calmelet
P
P
Charpentier
A
A
Raiga
J
J
Schaeffer
R
R
Treisser
A
A
Brettes
J P
JP
D000328:Adult; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D001022:Aortic Valve Insufficiency / Q000209:etiology; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D011256:Pregnancy Outcome; D012307:Risk Factors