Outcomes in pregnant women with acute aortic dissections: a review of the literature from 2003 to 2013.

Published

Journal Article (Review)

BACKGROUND: Acute aortic dissection in pregnant women is a rare but potentially life-threatening event. Our aim was to evaluate maternal and fetal outcomes of acute aortic dissection during pregnancy. METHODS: We conducted a review of literature of the PubMed database to identify publications related to pregnant women with acute aortic dissections during the period 2003-2013: 59 articles were included in the study. RESULTS: A total of 75 patients were included in the analyses. Stanford type A dissections were the most common form, accounting for 77% of all cases. The majority (78%) occurred in the third trimester and immediate postpartum period. Inherited connective tissue disorders were causative in 49% of patients. Maternal mortality was not statistical different between type A and type B dissections (21% vs. 23%), but fetal outcomes were worse in type B dissections (35% vs. 10.3%; P<0.05). Fetal mortality in type A dissections was dependent on the timing of aortic repair, with antepartum aortic repair associated with a higher mortality (36%). CONCLUSION: Despite advances in diagnostic and surgical techniques, maternal and fetal mortalities in pregnant patients with aortic dissection remain high. Patients undergoing combined cesarean section with aortic repair had favorable fetal outcomes.

Full Text

Duke Authors

Cited Authors

  • Rajagopalan, S; Nwazota, N; Chandrasekhar, S

Published Date

  • November 2014

Published In

Volume / Issue

  • 23 / 4

Start / End Page

  • 348 - 356

PubMed ID

  • 25223644

Pubmed Central ID

  • 25223644

Electronic International Standard Serial Number (EISSN)

  • 1532-3374

International Standard Serial Number (ISSN)

  • 0959-289X

Digital Object Identifier (DOI)

  • 10.1016/j.ijoa.2014.05.001

Language

  • eng