Acute type B aortic dissection in a pregnant woman with undiagnosed Marfan syndrome: A case report and review of the literature

• Published in: Case reports in women's health Vol. 32; p. e00342
• Main Authors: Miyazaki, Yumiko, Orisaka, Makoto, Kato, Masataka, Kawamura, Hiroshi, Kurokawa, Tetsuji, Yoshida, Yoshio
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.10.2021; Elsevier
• Subjects: Marfan syndrome; Multidisciplinary team; Pregnancy; Type B aortic dissection; Pregnancy; CT; TTE; AoD; Type B aortic dissection; HR; Multidisciplinary team; Marfan syndrome; bpm
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2021.e00342

Aortic dissection during pregnancy is rare but can be life-threatening to both the mother and the foetus. Marfan syndrome is a major risk factor for acute aortic dissection during pregnancy. Here, we present the case of a woman who had not been diagnosed with Marfan syndrome prior to pregnancy and who developed acute type B dissection at 32 weeks of gestation. The maternal hemodynamic status was stable, and foetal well-being was ensured. However, under conservative treatment, the dissection extended to the descending aorta, reaching the bilateral iliac artery 2 days later. Due to foetal distress, preterm delivery was performed via caesarean section. The primary treatment of type B aortic dissection is conservative medical treatment, with the goals of hemodynamic stabilisation, minimising the extent of the dissection and decreasing the risk of rupture. However, type B aortic dissection, even the uncomplicated type, in pregnant women may require early and aggressive obstetric interventions to improve maternal and foetal prognoses. •Type B aortic dissection during pregnancy can extend under medical treatment.•Aortic dissection in pregnant women may require aggressive obstetric intervention.•Marfan syndrome should be diagnosed before pregnancy to prevent aortic dissection.