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Pregnancy complicated with severe recurrent aortic coarctation: a case report
Celal Yavuz1, Hatice Ender Soydinc, Güven Tekbaş
1Department of Cardiovascular Surgery, Faculty of Medicine, Dicle University, 21280 Diyarbakir, Turkey.
Case Reports in Vascular Medicine
|November 8, 2012
Summary
This case study highlights the successful management of pregnancy in a patient with a history of aortic coarctation repair. Effective blood pressure control with metoprolol ensured a healthy mother and baby during delivery.
Area of Science:
- Cardiovascular Medicine
- Maternal-Fetal Medicine
- Congenital Heart Disease
Background:
- Pregnancy in women with a history of congenital aortic coarctation presents significant cardiovascular risks.
- Aortic coarctation, a congenital narrowing of the aorta, requires careful monitoring during gestation.
- Previous surgical repair of aortic coarctation and patent ductus arteriosus necessitates specialized obstetric care.
Purpose of the Study:
- To review the diagnosis and management of aortic coarctation during pregnancy.
- To present a case of successful pregnancy management in a patient with repaired aortic coarctation.
- To discuss the implications of congenital heart disease on maternal and fetal outcomes.
Main Methods:
- Case report of a 23-year-old primigravida with a history of aortic coarctation repair.
- Clinical evaluation including blood pressure measurements in upper and lower extremities.
- Transthoracic echocardiography to assess aortic arch diameter and pressure gradient.
- Pharmacological management of hypertension with metoprolol throughout gestation.
- Delivery via Cesarean section under spinal anesthesia.
Main Results:
- Elevated blood pressure (155/95 mmHg) in the upper extremity and a significant pressure gradient (96 mmHg) across the descending aorta were noted.
- Metoprolol effectively regulated blood pressure from 16 to 38 weeks of gestation.
- Cesarean delivery at 38 weeks resulted in a healthy infant (APGAR 10/10) with no postpartum complications.
Conclusions:
- Pregnancy can be managed successfully in patients with a history of aortic coarctation repair with appropriate medical supervision.
- Close monitoring of blood pressure and cardiac function is crucial throughout pregnancy.
- Pharmacological management and timely delivery planning are key to optimizing maternal and fetal outcomes.
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