A cohort study to examine the clinical characteristics, imaging features and outcomes in women with pregnancy-related acute aortic dissection showed that most cases are due to an aortopathy often not diagnosed until after aortic dissection, according to an article published in JAMA Cardiology.
The analysis included 29 women with aortic dissection during pregnancy or less than 12 weeks post-partum, representing 1 per cent of women in the International Registry of Acute Aortic Dissection. Outcome measures included underlying aortopathy, aortic size, type of aortic dissection, timing of dissection, hypertension, and previous aortic surgery.
Acute type A aortic dissection occurred in 13 women (45%) and type B aortic dissection occurred in 16 women (55%). Aortic dissection onset was known in 27 women (93%). In 15 women it occurred during pregnancy, four in the first trimester, 11 in the third trimester, and 12 were post-partum. Most women had an underlying aortopathy condition, but many were previously unaware of this diagnosis.
Acute aortic dissection related to pregnancy is a rare complication, but recognising women with a predisposition to aortic dissection, counselling them before conception, and monitoring the aorta throughout pregnancy may lessen the risk and improve outcomes, the authors conclude.