The Impact of Pregnancy in Patients with Thoracic Aortic Disease: Epidemiology, Risk Assessment, and Management Considerations.
Valeria E DuarteJessica N RichardsonMichael N SinghPublished in: Methodist DeBakey cardiovascular journal (2024)
Thoracic aortic disease (TAD) poses substantial risks during pregnancy, particularly for women with genetic conditions such as Marfan syndrome, Loeys-Dietz syndrome, and vascular Ehlers-Danlos syndrome. This review examines the epidemiology, risk assessment, and management of TAD in pregnancy. Preconception counseling is vital considering the hereditary nature of TAD and potential pregnancy-related complications. Genetic testing and imaging surveillance aid in risk assessment. Medical management, including beta-blockade and strict blood pressure control, is essential throughout pregnancy. Surgical interventions may be necessary in certain cases. A multidisciplinary approach involving cardiologists, obstetricians, cardiac surgeons, anesthesiologists, and other specialists with expertise in cardio-obstetrics is essential for optimal outcomes. Patient education and shared decision-making play vital roles in navigating the complexities of TAD in pregnancy and improving maternal and neonatal outcomes.
Keyphrases
- risk assessment
- pregnancy outcomes
- preterm birth
- human health
- blood pressure
- case report
- healthcare
- heavy metals
- risk factors
- aortic valve
- left ventricular
- spinal cord
- quality improvement
- public health
- high resolution
- pregnant women
- physical activity
- gene expression
- pulmonary artery
- aortic dissection
- spinal cord injury
- mass spectrometry
- heart failure
- genome wide
- coronary artery
- insulin resistance
- dna methylation
- pulmonary arterial hypertension
- hepatitis c virus
- human immunodeficiency virus
- fluorescence imaging
- climate change