Clinical characteristics of pregnancy complicated by aortic dissection and pregnancy outcome

Zhang Haofeng; Liang Xiaojun; Yang Dong; Zhang Dawei; Lin Yun; Li Zhizhong; Qiao Zhiyu; Zhang Jun

doi:10.3969/j.issn.1674-4055.2024.01.18

Abstract：Objective To discuss the clinical characteristics and pregnancy outcome in patients with aortic dissection during pregnancy.Methods The clinical materials were retrospectively collected in patients with pregnancy-related aortic dissection undergone termination of pregnancy in Department of Obstetrics and Gynecology or Department of Heart Surgery in Beijing Anzhen Hospital affiliated to Capital Medical University from Jan.2012 to Oct.2023.All patients were divided,according to types of aortic dissection,into type A group and type B group.The clinical characteristics and pregnancy outcome were analyzed through consulting clinical materials in electronic medical record system.Results Among 54 patients with pregnancy-related aortic dissection,there were 34(63%)in type A group and 20(37%)in type B group,and aortic dissection occurred mainly in the third trimester and most patients were complicated by aortectasia.The pregnancy-related aortic dissection was common in women aged under 35 years old.The difference in heart function classification had statistical significance between 2 groups(P<0.05).The patients with clinical symptoms,mainly chest and back pain,accounted for 85.19%(46/54).Among 54 patients,there were 20(37.04%)with miscarriages,24(44.44%)with preterm births,9(16.67%)with full-term births,including 7 with intrauterine death,12 with neonatal asphyxia and 16 with low birth weight infants.Among 54 patients,46 received cesarean section or hysterotomy for terminating pregnancy,42 received cardiac surgery,including 27(25 in type A group,2 in type B group)received obstetric surgery combined with cardiac surgery.Conclusion The risk of pregnancy-related aortic dissection is higher,which needs a co-management by multi-disciplinary team.