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[Marfan syndrome and pregnancy. Apropos of 4 cases]
E Lambaudie1, S Depret-Mosser, B Occelli
1Service de pathologie maternelle et foetale, hôpital Jeanne de Flandre, CHRU de Lille, place de Verdun, 59000 Lille, France. elambaudie@nordnet.fr
Objectives:
To create a follow-up protocol for pregnant patients with Marfan syndrome.
Patients And Methods:
We retrospectively reviewed the charts of patients who delivered in the Jeanne de Flandre University Hospital between June 1996 and June 1999. Four pregnant patients with Marfan syndrome were identified.
Results:
Three of these patients had Bentall procedure. One of them had vaginal delivery and the two others underwent cesarean section. One of these two patients developed aortic valve thrombus at 14 weeks of amenorrhea. The fourth patient did not have surgery and had two vaginal deliveries.
Discussion:
According to our results and after reviewing literature pregnant patients with Marfan syndrome were divided into two groups. The 1st group was comprised of patients who underwent Bentall procedure. The 2nd one was comprised of patients who did not undergo any surgical procedure. The possibility of vaginal delivery for patients who underwent Bentall procedure (one case) and the interest of Propanolol and anticoagulant treatment are emphasized.
Conclusion:
The multivariant approach of pregnant patients with Marfan syndrome is stressed out with special reference to the potential complications of this syndrome such as aortic dissection and to the problems related to the anticoagulant treatment.