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Pregnancy outcome in thoracic aortic disease data from the Registry Of Pregnancy And Cardiac disease

Laurence Campens1, Lucia Baris2, Nandita S Scott3

  • 1Department of Cardiology, Ghent University Hospital, Gent, Belgium.

Heart (British Cardiac Society)
|January 20, 2021
PubMed

Insights

Pregnancy in women with thoracic aortic disease, including Marfan syndrome, generally has good outcomes when managed with current guidelines. Acute aortic dissection during pregnancy did not result in maternal or fetal mortality in this study.

Area of Science:

  • Cardiology
  • Genetics
  • Obstetrics

Background:

  • Cardiovascular disease is a leading cause of pregnancy-related death, with thoracic aortic dissection being a significant factor.
  • Thoracic aortic disease is often linked to hereditary conditions and congenital heart defects like bicuspid aortic valve (BAV).
  • Pregnancy poses a high risk for women with pre-existing aortopathy.

Purpose of the Study:

  • To investigate maternal and fetal outcomes in pregnant women with thoracic aortic disease.
  • To analyze data from the prospective global ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC) registry.
  • To assess the safety and risks associated with thoracic aortic disease during pregnancy.

Main Methods:

  • Analysis of data from the ROPAC registry, which prospectively enrolled 5739 women with cardiac disease.
  • Focus on a subgroup of 189 women diagnosed with thoracic aortic disease.
  • Review of maternal and fetal outcomes, including aortic dissection events and birth weights.

Main Results:

  • Thoracic aortic disease was present in 3.3% of women, with Marfan syndrome (50%) and BAV (26%) being common causes.
  • Aortic dilatation affected 58% of patients; 6% had a history of aortic dissection.
  • Four cases of acute aortic dissection occurred (three Type A, one Type B) without maternal or fetal mortality. Beta-blocker use did not significantly impact fetal birth weight.

Conclusions:

  • This study represents the largest prospective review of pregnancy risks in women with thoracic aortic disease.
  • Overall pregnancy outcomes for women with thoracic aortic disease are favorable when managed according to current guidelines.
  • Adherence to established guidelines ensures good outcomes for both mother and fetus in this high-risk population.
Abstract

Keywords:
Marfan and associated disordersaortic and arterial diseaseaortic aneurysmbicuspid aortic valvepregnancy

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