Cardiovascular problems in pregnant women with Marfan syndrome

Abstract

Our case scenario presents some of the challenges faced by the pregnant patient with MFS and her physicians. Although diagnosed at a young age, she was not treated with β-blockers and did not have a preconception evaluation and thus was exposed to a high risk of acute aortic dissection during pregnancy. A finding of a dilated aorta before pregnancy would have mandated surgery before conception. The case also demonstrates the dilemma faced by the patient of having surgery during pregnancy, which is associated with high rate of fetal loss and other fetal complications. Because of concern for her fetus, the patient preferred to assume the risk herself and delayed the surgery to allow fetal maturity and delivery of the baby before the operation. Because of an increased risk of aortic dissection due to the hemodynamic strain involved with vaginal delivery, the delivery was done by cesarean section. © 2009 American Heart Association, Inc.