医学
怀孕
主动脉夹层
解剖(医学)
血压
遗传咨询
重症监护医学
产科
外科
内科学
遗传学
生物
主动脉
作者
Stephanie Curtis,Lorna Swan
出处
期刊:Heart
[BMJ]
日期:2022-02-10
卷期号:108 (23): 1851-1857
被引量:13
标识
DOI:10.1136/heartjnl-2021-319828
摘要
Aortic dissection is one of the most common causes of death in pregnancy. Most cases are caused by hereditary thoracic aortopathy (HTA), and women are often unaware they are at risk. Awareness, early recognition and involvement of senior clinicians from the expert cardio-obstetric team are essential to facilitate early diagnosis and carefully planned and coordinated antenatal and postnatal care. Frequent imaging antenatally and good blood pressure control are key. Delivery needs particular attention with optimal pain control and techniques to minimise maternal effort. Dissection is most common post partum and a period of close surveillance with meticulous blood pressure control after delivery is crucial, as well as follow-up of the baby in paediatric services. All women with a family history of aortic dissection or sudden death should be investigated. Women with known HTA should be offered specialist individualised pre-pregnancy counselling, including advice about genetics and inheritance, before starting a family. Future research is directed towards more individualised risk assessment, pre-pregnancy advice and pharmacological options to reduce dissection risk.
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