Peripartum aortic dissection: a rare case of Stanford type B dissection triggered by severe labor pain

Peripartum aortic dissection (AD) is an uncommon yet significant complication during pregnancy and delivery, characterized by a tear in the aortic intima that can lead to severe maternal morbidity and mortality. This case report describes a rare instance of Stanford Type B aortic dissection occurring in a pregnant woman, emphasizing that acute, severe labor pain can obscure the diagnosis of AD, often leading to misattribution of symptoms to more common obstetric complications.

This report highlights the case of a 36-year-old primigravida who presented with acute chest pain during labor, initially misdiagnosed until imaging revealed the dissection post-delivery. The critical interplay between labor-induced hemodynamic stress and pre-existing vascular weaknesses, such as those found in connective tissue disorders, raises concerns about the cardiovascular risks faced by pregnant individuals. The importance of a multidisciplinary approach, involving obstetricians, cardiologists, and anesthesiologists, is underscored, as effective management strategies are essential to ensure maternal and fetal safety.

This case underscores the necessity for healthcare providers to maintain a high index of suspicion for atypical thoracic pain in pregnant patients and advocates for enhanced screening protocols for aortic disease. The findings advocate for regular cardiovascular assessments in women of childbearing age with known risk factors to improve early diagnosis and intervention, thereby potentially reducing the associated morbidity and mortality from this rare but critical condition. Further research is needed to develop evidence-based guidelines for managing AD in the peripartum setting, aiming to refine clinical protocols and optimize patient outcomes.