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Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
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Obstetric considerations for aortopathy in pregnancy
Anna R Whelan1, Myles E Ringel2, Sherene Shalhub3
1Department of Maternal-Fetal Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Annals of Cardiothoracic Surgery
|December 13, 2023
Summary
Pregnancy-associated aortic dissection (AD) is rare but serious, often occurring late in pregnancy or postpartum. Management involves a multidisciplinary team and careful monitoring to ensure maternal and fetal safety.
Area of Science:
- Cardiovascular Medicine
- Maternal-Fetal Medicine
- Genetics
Background:
- Aortic dissection (AD) during pregnancy poses severe risks to mother and fetus.
- It is a leading cause of maternal cardiovascular death.
- Risk is elevated in individuals with genetic aortopathy.
Purpose of the Study:
- To outline management strategies for pregnancy-associated aortic dissection.
- To emphasize the importance of a multidisciplinary approach.
- To inform patient counseling regarding pregnancy risks.
Main Methods:
- Review of management strategies across preconception, antepartum, delivery, and postpartum periods.
- Utilization of imaging modalities like echocardiogram and MRI for surveillance.
- Selective use of CT scans to minimize fetal radiation exposure.
Main Results:
- Pregnancy-associated AD most commonly occurs in the third trimester or postpartum.
- Genetic aortopathy significantly increases AD risk during pregnancy.
- Multidisciplinary teams and appropriate imaging are crucial for management.
Conclusions:
- Comprehensive management strategies are vital for optimizing care in pregnancy-associated AD.
- Informed decision-making through patient counseling is essential.
- A coordinated cardio-obstetric team approach ensures patient safety.
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