Saeidi Mahmoud, Movahedi Minoo, Bahrami Parvin, Shokrani-Foroushani Reza, Sheikhbahaei Erfan
Assistant Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute AND Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Associate Professor, Department of Obstetrics and Gynecology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2021 Mar;17(2):1-4. doi: 10.22122/arya.v17i0.2110.
The most dramatic diseases in the aorta are aortic dissection and aneurysm, which both of them are common in pregnant women with Marfan syndrome (MFS). According to recommendations in existing guidelines, pregnancy is not recommended in patients with severe dilation of the aorta and patients with MFS with aortic dilation > 45 mm should have prophylactic aortic repair before pregnancy.
In this rare and unique report, we described a 34-year-old pregnant woman with marfanoid feature who had an approximate aortic root of 60 mm and severe aortic insufficiency. She denied terminating the pregnancy at her first prenatal visit and continued it until 30 weeks of gestation and the pregnancy terminated in the cardiac operating room due to multiple episodes of chest pain. No complication occurred during her close observation before surgery. The aortic repair was performed for her after the cesarean section.
Pregnancy with severe aortic root dilation is high-risk for all patients; however, if it occurs, when the mother denies an abortion, inform the patient about its risk and continue the pregnancy with close observation and tight blood pressure (BP) control until the fetus becomes viable.
主动脉最严重的疾病是主动脉夹层和动脉瘤，这两种疾病在患有马凡综合征（MFS）的孕妇中都很常见。根据现有指南中的建议，不建议主动脉严重扩张的患者怀孕，主动脉扩张>45mm的MFS患者应在怀孕前进行预防性主动脉修复。
在这份罕见且独特的报告中，我们描述了一名34岁具有马凡样特征的孕妇，其主动脉根部约为60mm，并有严重的主动脉瓣关闭不全。她在首次产前检查时拒绝终止妊娠，并持续到妊娠30周，因多次胸痛在心脏手术室终止妊娠。在手术前的密切观察期间未发生并发症。剖宫产术后为她进行了主动脉修复。
对于所有患者来说，伴有严重主动脉根部扩张的妊娠都是高风险的；然而，如果发生这种情况，当母亲拒绝堕胎时，告知患者其风险，并在密切观察和严格控制血压的情况下继续妊娠，直到胎儿能够存活。
