title: Aorta pathology and pregnancy.
abstract: In addition to the haemodynamic changes in pregnancy, hormones also induce changes in the aortic wall. Women with diseases like Marfan syndrome, Ehlers-Danlo syndrome, or other aortic abnormalities, have an increased risk of complications during pregnancy. Counselling and risk assessment before pregnancy is mandatory for all women with known aortic disease. Proper information should be provided about the risks of morbidity and mortality during pregnancy and information on the risks for the fetus, including the potential recurrence of disease in the offspring. Evaluation of past medical and family history, the aortic size before conception, and any increase in size before and during pregnancy, is essential to try and estimate the risk of aortic dissection. If the aorta is dilated, prophylactic repair before pregnancy may be indicated. In some cases, elective surgery during pregnancy may be warranted. In women with a severely dilated ascending aorta, caesarean section is, at present, the advised mode of delivery.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Iris M
authors.initials: IM
authors.lastname: van Hagen
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Electronic address: j.roos@erasmusmc.nl.
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
mesh_terms: D001011:Aorta / Q000473:pathology* / Q000503:physiopathology; D001018:Aortic Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D004108:Dilatation, Pathologic / Q000517:prevention & control; D037001:Directive Counseling; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications*; D016742:Preconception Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology* / Q000503:physiopathology; D014424:Turner Syndrome / Q000150:complications*
keywords: Ehlers–Danlos syndrome; Loeys–Dietz syndrome; Marfan syndrome; Smad3 protein; Turner syndrome; aortic aneurysm; dissection; pregnancy