Aortic disease and pregnancy

Abstract

Purpose of review: During pregnancy, cardiac disease is the most important cause of maternal mortality, with aortic disease being the most important contributor. This review describes the impact of pregnancy, risk stratification for and the management of aortic diseases during pregnancy and delivery.

Recent findings: The most common aortic diseases with an increased risk of complications during pregnancy are genetic syndromes such as Marfan, Loeys-Dietz, vascular Ehlers-Danlos, Turner syndrome and bicuspid aortic valve. The key management of aortic dilatation consists of prepregnancy counseling, including imaging of the entire aorta and preventive treatment when indicated. The possible treatment options for aortic dissection during pregnancy are medication and surgical treatment. Percutaneous interventions are associated with a high risk.

Summary: The heterogeneity of aortic diseases underlines the need for an individual risk assessment and management. A dedicated plan for diagnosis, management, follow-up, labor and delivery should be formulated by an experienced multidisciplinary team.