[Clinical analysis of pregnancy and postpartum cardiovascular complications in Marfan syndrome].
OBJECTIVE
To investigate the management of pregnancy and cardiovascular complications in women with Marfan syndrome (MFS).


METHODS
From October 1994 to September 2006, 30 patients with MFS undergoing cardiovascular surgery were studied retrospectively.


RESULTS
In the labor of 46 offsprings given birth by 30 women, 5 cases (11%) were performed elective cesarean section because of the existence of aortic complication, and 12 (26%) were diagnosed as MFS. The gestation in two patients was terminated due to deterioration of aortic abnormalities during their third trimester, and they received surgical treatment with Bentall procedure. Two developed acute aortic dissection during labor and post delivery respectively. With the manipulation of anticoagulation peripartum, one who had the implantation with mechanical prosthesis went through pregnancy and delivery uneventfully. The average duration between delivery and cardiovascular surgery was (15 +/- 9) years.


CONCLUSIONS
Vaginal delivery can be done safely in patients with the MFS who do not have or have mild cardiovascular system abnormalities, aortic dissection, or other important cardiac abnormalities, cesarean section should be the preferred method of delivery. Women with MFS are at increased risk for dissection and congestive heart failure during pregnancy and should be counseled before pregnancy about these risks, as well as the inheritance of the condition.
Xie
Jin-sheng
JS
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China. jshxie27@sohu.com
Li
Bin
B
Sun
Yan-qing
YQ
Guan
Xin-liang
XL
Xu
Bao-wei
BW
Qiao
Zhi-yu
ZY
D000328:Adult; D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications*; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D055815:Young Adult