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妊娠与胸主动脉疾病:管理风险。

Pregnancy and Thoracic Aortic Disease: Managing the Risks.

机构信息

Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands; Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of The Netherlands, Utrecht, The Netherlands.

Division of Cardiology, Department of Medicine, Mount Sinai Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.

出版信息

Can J Cardiol. 2016 Jan;32(1):78-85. doi: 10.1016/j.cjca.2015.09.003. Epub 2015 Sep 18.

Abstract

The most common aortopathies in women of childbearing age are bicuspid aortic valve, coarctation of the aorta, Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, SMAD3 aortopathy, Turner syndrome, and familial thoracic aneurysm and dissection. The hemodynamic and hormonal changes of pregnancy increase the risk of progressive dilatation or dissection of the aorta in these women. The presence of hypertension increases the risk further. Therefore, appropriate preconception counselling is advised. For women who become pregnant, serial follow-up by a specialized multidisciplinary team throughout pregnancy and postpartum period is required. In this review we discuss risk assessment and management strategies for women with aortopathies.

摘要

生育年龄女性最常见的主动脉病变包括二叶式主动脉瓣、主动脉缩窄、马凡综合征、埃勒斯-当洛斯综合征、洛伊兹-迪茨综合征、SMAD3 主动脉病变、特纳综合征和家族性胸主动脉瘤和夹层。妊娠期间的血流动力学和激素变化会增加这些女性主动脉进行性扩张或夹层的风险。高血压的存在会进一步增加这种风险。因此,建议进行适当的孕前咨询。对于怀孕的女性,需要由专门的多学科团队在整个孕期和产后进行定期随访。在这篇综述中,我们讨论了主动脉病变女性的风险评估和管理策略。

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