Aortic aneurysm of major vessels during pregnancy. Multidisciplinary approach

Authors

  • Iu.V. Davydova SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine»; SI «Amosov National Institute of Cardiovascular Surgery», Ukraine
  • S.O. Siromaha SI «Amosov National Institute of Cardiovascular Surgery», Ukraine
  • V.I. Kravchenko SI «Amosov National Institute of Cardiovascular Surgery», Ukraine
  • A.Y. Lymanska SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine
  • О.М. Naumchik SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine

DOI:

https://doi.org/10.15574/PP.2020.82.27

Keywords:

aortopathy, aortic dissection, pregnancy, aortic aneurysm, type А aortic dissection, thoracic aortic aneurysm

Abstract

Purpose — to develop an algorithm of obstetric and cardiac surgical tactics in women of reproductive age with aneurysmal lesions of the major vessels.

Materials and methods. An analysis of the world experience of managing patients with aortopathies combined with pregnancy from English, Ukrainian, Russian literature sources of databases PubMed, Medscape, Google Search, Elsevier for the last 10 years. 19 sources were analyzed, which included review articles, data from cohort studies. The publications with the largest series of analyzed cases were selected for analysis. Review articles were selected with the largest number of analyzed studies. The guidelines of the European Society of Cardiology 2018 (ESC 2018) were taken into account to determine the recommendations. The experience of the multidisciplinary team «Obstetric Cardiology» with this group of pregnant women for 6 years is presented.

Results and conclusions. Marphan syndrome is recognized as a leading risk factor for aortic dissection during pregnancy. The most dangerous are the third trimester of pregnancy and the postpartum period. Preconception counseling of women risk-group is substantial, it is important also for identification of women who are contraindicated in pregnancy without elimination of pathological conditions of the aorta, as well as the development of an individual pregnancy plan by a multidisciplinary team with a proven algorithm for tactical decisions in case of complications. The multidisciplinary team «Obstetric Cardiology» uses recognized global trends in the treatment of women with aortic dissection in the antenatal and postnatal periods with successful results.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies.

 

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Published

2020-06-29

Issue

No. 2(78) (2020): Ukrainian Journal of Perinatology and Pediatrics

Section

Original articles

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