Abstract:

Objective To explore the clinical manifestations, diagnosis and treatment of aortic dissection during pregnancy. Methods A retrospective analysis of clinical data, auxiliary examination, therapeutic regimen, maternal-fetal outcomes of 6 pregnancy patients complicated with aortic dissection, who admitted to the Henan Provincial people's Hospital from January 2015 to December 2020 was performed, in order to explore the influence for the outcome on different operation time. Results Those patients ranged 30 to 38 years, with mean age 32.16 years; age at the the time of onset ranged from 5-week pregnancy to 1-month postpartum; there were 2 cases in first trimester, 3 cases in third trmester, and 1 case in the puerperium. The cardinal symptom included 4 cases of pain in chest and back, 1 case of hest pain and panting, and 1 case of low back pain. All patients perpormed aortic angiography, in term of classification of aortic dissection, 4 cases were Stanford type A, and 2 cases were Stanford type B. All patients underwent aortic surgery, simultaneous aortic surgery and pregnancy termination were performed in 3 case (1 case of hysterectomy and 2 cases of retained uterus); the pregnancy was terminated after aortic surgery in 2 cases (Bentall surgery first, pregnancy termination on week 1 postoperative); aortic surgery was performed in 1 case during the puerperium. No postoperative mortality was reported. There were 2 fetuses of induced abortion, and 4 fetuses of surviver with good follow-up maternal-fetal outcome. Conclusion For aortic dissection during pregnancy, the treatment regimen should be fully evaluated the scope and type of aortic dissection, the gestational age of the fetus, and the pregnant woman's willingness. The appropriate timing of surgery should be selected to ensure the safety of mother and fetus, and futher reduce the mortality rate.

Key words: pregnancy, pregnancy outcome, aortic dissection