Acute type B aortic dissection in a pregnant woman with undiagnosed Marfan syndrome: A case report and review of the literature

Case Rep Womens Health. 2021 Jul 16:32:e00342. doi: 10.1016/j.crwh.2021.e00342. eCollection 2021 Oct.

Abstract

Aortic dissection during pregnancy is rare but can be life-threatening to both the mother and the foetus. Marfan syndrome is a major risk factor for acute aortic dissection during pregnancy. Here, we present the case of a woman who had not been diagnosed with Marfan syndrome prior to pregnancy and who developed acute type B dissection at 32 weeks of gestation. The maternal hemodynamic status was stable, and foetal well-being was ensured. However, under conservative treatment, the dissection extended to the descending aorta, reaching the bilateral iliac artery 2 days later. Due to foetal distress, preterm delivery was performed via caesarean section. The primary treatment of type B aortic dissection is conservative medical treatment, with the goals of hemodynamic stabilisation, minimising the extent of the dissection and decreasing the risk of rupture. However, type B aortic dissection, even the uncomplicated type, in pregnant women may require early and aggressive obstetric interventions to improve maternal and foetal prognoses.

Keywords: AoD, Acute aortic dissection; CT, computed tomography; HR, heart rate; Marfan syndrome; Multidisciplinary team; Pregnancy; TTE, Transthoracic echocardiography; Type B aortic dissection; bpm, beats per minute.

Publication types

  • Case Reports