成人先天性心脏病中的主动脉病变与妊娠相关风险：孕期主动脉会扩张吗？
Aorta pathology and pregnancy-related risks in adult congenital cardiac disease: does the aorta dilate during pregnancy?
作者信息
Ceuppens Anne-Sophie, De Meester Pieter, Van De Bruaene Alexander, Voigt Jens-Uwe, Van Calsteren Kristel, Budts Werner, Troost Els
机构信息
Congenital and Structural Cardiology, University Hospitals Leuven, Belgium.
Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Belgium.
出版信息
Obstet Med. 2024 Mar;17(1):41-46. doi: 10.1177/1753495X231156851. Epub 2023 Feb 28.
BACKGROUND
Aortic dilatation and pregnancy are major concerns in women with aortopathy (AOP). This single-centre retrospective analysis focuses on the evolution of aortic diameters during and after pregnancy in women with Marfan syndrome (MS), Turner syndrome (TS) and bicuspid aortic valve (BAV) aortopathy.
METHODS AND RESULTS
Thirty-eight women who had one or more single pregnancies were included. The ascending aorta was measured during pregnancy and postpartum. During pregnancy, a significant increase of diameters of the sinus aortae (median 1.4 mm; [-1.3; 3.8]) and ascending aorta (median 2.1 mm; [0.0; 4.0]) was noted. Systemic hypertension gives dilation of the aorta, but it did not influence the overall trajectory during pregnancy.
CONCLUSION
Significant aortic dilatation is noted during pregnancy in women with underlying AOP, even persisting in the long term. Pre-existing systemic hypertension is associated with larger aortic diameters prior to pregnancy. More research on a larger study population however is needed.
背景
主动脉扩张和妊娠是患有主动脉病变（AOP）女性的主要关注点。这项单中心回顾性分析聚焦于患有马凡综合征（MS）、特纳综合征（TS）和二叶式主动脉瓣（BAV）主动脉病变的女性在妊娠期间及产后主动脉直径的变化情况。
方法与结果
纳入了38名有过一次或多次单胎妊娠的女性。在孕期和产后测量升主动脉。孕期，主动脉窦直径（中位数1.4 mm；[-1.3；3.8]）和升主动脉直径（中位数2.1 mm；[0.0；4.0]）显著增加。系统性高血压会导致主动脉扩张，但它并未影响孕期的整体变化轨迹。
结论
患有潜在AOP的女性在孕期会出现显著的主动脉扩张，甚至长期持续。既往存在的系统性高血压与妊娠前较大的主动脉直径相关。然而，需要对更大的研究人群进行更多研究。
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