Aortic aneurysms in pregnancy are rare but often fatal due to the natural physiologic changes of pregnancy and comorbidities specific to pregnancy, which increase the risk for aortic dissection and rupture. These physiologic changes are most pronounced in the third trimester and during the peripartum period, when approximately one third of dissections occur. In patients with known aortic aneurysms or conditions that make them prone to aortic aneurysms, preconception counseling can make pregnancy safer and more manageable. Aortic aneurysms diagnosed during pregnancy are usually due to underlying connective tissue diseases or aortopathies that have not been previously diagnosed. These women require multidisciplinary care including but not limited to obstetrics and gynecology, maternal fetal medicine, neonatology, cardiology, cardiothoracic surgery, cardiothoracic anesthesia, and genetics. Decisions include screening for dissection, when to proceed with surgical management, the best mode and timing for delivery, postpartum care, and contraception.
Part of the book: Aortic Aneurysm