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Obstetric complications in Marfan syndrome
Lilian J Meijboom1, Willem Drenthen, Petronella G Pieper
1Department of Cardiology, Rm B2-240, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, and Department of Cardiology, Radboud Hospital Nijmegen, The Netherlands.
Objective:
To investigate the obstetric maternal and neonatal outcome of pregnancy in women with Marfan syndrome.
Methods:
Retrospective observational multi-center study based on congenital heart disease registry.
Results:
Sixty-three of the 122 enrolled women with Marfan syndrome had been pregnant 142 times (including 111 pregnancies>20 weeks, 28 (20%) miscarriages and 3 elective abortions). In 40% of all completed pregnancies an obstetric and/ or neonatal complication occurred. The most important complications were an increased percentage of premature deliveries (n=17, 15%) mainly due to preterm premature rupture of membranes and cervical incompetence and a markedly increased combined fetal and neonatal mortality of 7.1%. An obstetric and/or neonatal complication occurred in a similar proportion of pregnancies in women with a diagnosis of Marfan syndrome before pregnancy versus women with a diagnosis of Marfan syndrome after pregnancy (39% vs. 41%, p=0.85, respectively).
Conclusion:
In addition to cardiovascular complications, pregnancy in women with Marfan syndrome is associated with a high rate of premature deliveries, preterm premature rupture of membranes and increased mortality in the offspring.
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