Loeys-Dietz syndrome in pregnancy: a case description and report of a novel mutation.
Loeys-Dietz syndrome is a syndrome caused by heterozygous mutations in the genes encoding type 1 or 2 transforming growth factor-beta receptor (TGF-beta-R1/2). The obstetrical manifestations are risk of rupture of the gravid uterus and the arteries, either during pregnancy or in the immediate postpartum period, and damage to the vagina, perineum and the colon. We describe, for the first time, a new TGF-beta-R2 gene mutation in a family with several individuals who either had aortic rupture and dissection, sudden death or aortic root dilatation. The pregnancy was followed up and the baby was successfully delivered by a cesarean section at 34 weeks of gestation. The mother's recovery was uneventful and the baby was negative for the mutation on postnatal molecular testing. With appropriate supervision and early delivery by cesarean section, women with Loeys-Dietz syndrome can tolerate pregnancy and delivery without any adverse effect.
Gutman
Guy
G
Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. gutguy10@yahoo.com
Baris
Hagit N
HN
Hirsch
Raphael
R
Mandel
Dror
D
Yaron
Yuval
Y
Lessing
Joseph B
JB
Kuperminc
Michael J
MJ
D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D055947:Loeys-Dietz Syndrome / Q000150:complications* / Q000235:genetics; D008297:Male; D008382:Marfan Syndrome / Q000235:genetics; D020125:Mutation, Missense; D011247:Pregnancy; D011248:Pregnancy Complications; D018125:Receptors, Transforming Growth Factor beta / Q000235:genetics
D018125:Receptors, Transforming Growth Factor beta