From the Departments of Surgery and Radiology, University of Virginia Health System, Charlottesville, Virginia.
Obstet Gynecol. 2012 Feb;119(2 Pt 2):480-483. doi: 10.1097/AOG.0b013e3182390622.
Fifty percent of aortic dissections in women younger than 40 years occur in association with pregnancy. Of these, half of type B dissections occur in the postpartum period.
A 30-year-old woman was status post spontaneous vaginal delivery at 30 weeks of gestation for fetal death, complicated by an eclamptic seizure. On postpartum day 4, she suffered an acute, complicated type B aortic dissection treated with endovascular stent graft placement.
Endovascular repair may be an attractive option for the treatment of complicated type B aortic dissections in pregnancy and the peripartum period, with reduced maternal and fetal mortality. This may allow the fetus to remain in situ and avoid the risks of surgery and possible cardiopulmonary bypass, with little radiation risk to the fetus.
40 岁以下女性中,50%的主动脉夹层与妊娠有关。其中,一半的 B 型夹层发生在产后。
一名 30 岁女性,因胎儿死亡行 30 周自发性阴道分娩,期间并发子痫发作。产后第 4 天,她突发急性、复杂型 B 型主动脉夹层,行血管内支架植入术治疗。
血管内修复术可能是妊娠和围产期复杂型 B 型主动脉夹层的一种有吸引力的治疗选择,可降低母婴死亡率。这可能使胎儿保持原位,避免手术和可能的体外循环的风险,对胎儿的辐射风险较小。