Acute Type-B Aortic Dissection in Pregnancy: Therapeutic Challenges in a Multidisciplinary Setting

Chronic Aortic Dissection and Pregnancy: Clinical Case Report

“…Delamination in the descending aorta characterized the dissection as type B and clinical treatment was chosen during the pregnancy, followed by the implantation of a thoracic endoprosthesis in the immediate postpartum. 3 , 8 , 9 The maternal hemodynamic stability and the strict monitoring of the aortic pathology and fetal vitality allowed this conduct in our service.…”

“…The decision about clinical management only or the need for surgical intervention before or after the pregnancy interruption should consider the risk of rupture, type of dissection and fetal viability. 3 , 8…”

“…9 They can be used with relative safety during pregnancy (Propranolol is a Class C drug by the Food and Drug Administration - FDA). 3 , 8 , 9…”

“…The pregnancy interruption prior to the dissection repair offered a greater chance of survival to this conceptus, since the reported rates of morbidity and mortality may reach 30% and 9%, respectively, during the repair procedures. 3 , 8…”

“…In the absence of acute dissection, normal delivery can be performed with an aortic diameter < 40 mm in cases of Marfan Syndrome, with a cesarean section being indicated above this reference value. 3 , 8 The carrying out of the delivery should include interventions to reduce aortic wall stress, strict blood pressure control, adequate analgesia, and instrumental delivery when indicated. 3 , 8 The patient's aorta had a maximum diameter of approximately five centimeters, which supported the choice of delivery route by the team.…”