• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Aortic Dissection in Pregnancy: What Are the Clinical Features?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Braverman et al. (JAMA Cardiol., 2020) examined clinical characteristics, imaging features, and outcomes in women with pregnancy-related acute aortic dissection

METHODS:

  • Cohort study (February 1, 1998 to February 28, 2018)
  • Data source
    • International Registry of Acute Aortic Dissection (IRAD)
  • Participants
    • Women with aortic dissection during pregnancy or <12 weeks postpartum
  • Primary outcomes
    • Clinical features of pregnancy-related aortic dissection: Underlying aortopathy | Aortic size | Type of aortic dissection | Timing of dissection | Hypertension | Previous aortic surgery

RESULTS:

  • 29 women with pregnancy-related aortic dissection were included
    • Mean (SD) age: 32 (6) years
      • 0.3% of all aortic dissections
      • 1% of aortic dissection in women in the IRAD
    • Age: 19% <35 years
  • Aortic dissection type
    • Type A (ascending aorta involved): 45%
    • Type B (ascending aorta not involved): 55% of women
  • Aortic dissection onset
    • During pregnancy: 15 women
      • First trimester: 4 women
      • Third trimester: 11 women
    • Postpartum: 12 women
      • Occurred a mean (SD) of 12.5 (14) days postpartum
  • Aortic diameters
    • Type A diagnosis
      • Sinus of Valsalva: mean (SD) 54.5 (5) mm
      • Ascending aorta: 54.7 (6) mm
    • Type B diagnosis
      • Descending aorta: 32.5 (5) mm
  • Aortopathy condition or a positive family history present in 69%
    • Marfan syndrome: 65%
    • Loeys-Dietz syndrome: 10%
    • Bicuspid aortic valves: 10%
    • Family history of aortic disease: 10%
    • Familial thoracic aortic aneurysm: 5%
  • Aortopathy was not recognized until after aortic dissection in 47% of the women
  • 97% of women survived aortic dissection hospitalization

CONCLUSION:

  • Aortic dissection with pregnancy is rare
  • Most patients had an underlying aortopathy and in approximately half of these cases, diagnosis was not established until after dissection  
  • Type A dissections were associated with a dilated aorta, while type B were not
  • The authors conclude

Recognizing women with predisposition to aortic dissection, counseling them before conception, and monitoring the aorta throughout pregnancy may lessen the risk of this rare complication of pregnancy and improve outcomes

Learn More – Primary Sources:

Clinical Features and Outcomes of Pregnancy-Related Acute Aortic Dissection

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Are Fluoroquinolones Truly Associated with Increased Risk of Aortic Dissection?
Is the Prognosis for Aortic Aneurysm Worse for Women than for Men?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Download Your ObG App
HERE!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site