title: A successful cesarean section followed with endovascular stent-graft implantation for a 36-week twin pregnancy with acute aortic dissection: a case report.
abstract: BACKGROUND
  It is a first case report for a woman pregnant with twins who suddenly ruptured with a Stanford type B aortic dissection.
  
  
  METHODS
  A 24-year-old pregnant patient gravida 1 and para 0 at the 36th gestation week was sent to our Emergency Department under the medical monitoring by the local gynecologist. Her primary complaints were that she suddenly felt "severe tearing chest pain". Ultrasound image illustrated fetal twins at cephalic positions about 36th gestation week. An emergent magnetic resonance angiography (MRA) of aorta is given below: dissection of the descending aorta arisen from the descending aorta to the bifurcation of abdominal aorta suggestive of Stanford type B aortic dissection.
  
  
  RESULTS
  The two babies were delivered by an emergent cesarean section and stent-graft placement of the descending thoracic aorta was performed on the mother thereafter.
  
  
  CONCLUSIONS
  This case report illustrates the value of comprehensive multidisciplinary discussion and collaboration among different departments to make quick decisions. Endovascular stent-graft repair may be the best option for the treatment of Stanford type B aortic dissection in late pregnancy.
authors: Department of Obstetrics and Gynecology, Jinling Hospital, School of Medicine, Nanjing University, Zhongshan East Road #305, Nanjing, 210002, Jiangsu, China.
authors: Qun
authors: Q
authors: Hao
authors: Department of General Surgery, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, Zhongshan Road #321, Nanjing, 210002, Jiangsu, China.
authors: Hao
authors: H
authors: Wang
authors: Department of Obstetrics and Gynecology, Jinling Hospital, School of Medicine, Nanjing University, Zhongshan East Road #305, Nanjing, 210002, Jiangsu, China.
authors: Cheng
authors: C
authors: Zhang
authors: Department of Obstetrics and Gynecology, Jinling Hospital, School of Medicine, Nanjing University, Zhongshan East Road #305, Nanjing, 210002, Jiangsu, China.
authors: Ai-Qing
authors: AQ
authors: Ma
authors: Department of Obstetrics and Gynecology, Jinling Hospital, School of Medicine, Nanjing University, Zhongshan East Road #305, Nanjing, 210002, Jiangsu, China. njzy305@sina.com.
authors: Yuan-Zhe
authors: YZ
authors: Wu
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D018810:Magnetic Resonance Angiography; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000601:surgery*; D011256:Pregnancy Outcome; D059285:Pregnancy, Twin; D011296:Prenatal Diagnosis / Q000379:methods; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aortic dissection; Cesarean section; Graft placement; Pregnancy
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