Document Detail


Fetomaternal blood flow measurements and management of combined coarctation and aneurysm of the thoracic aorta in pregnancy.
MedLine Citation:
PMID:  8392275     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A pregnant patient presented at 21 weeks of gestation with severe coarctation of the aorta and a large aneurysm (5.4 cm) of the ascending aorta. The patient developed hypertension at gestation week 17. Continuous Doppler wave velocimetry showed a low systolic/diastolic (S/D) ratio in the uterine arteries indicating reduced blood flow to the placenta. The presence of a severe coarctation, aneurysm of the ascending aorta, and hypertension associated with the hemodynamic changes of pregnancy, increases maternal and fetal risk. The literature reviewed disclosed that aneurysm expansion and dissection or rupture on the one hand, and fetal demise on the other, are the greatest risks. The challenge of treating both the patient and the fetus was managed successfully by correction of the coarctation at week 22. Blood pressure normalized a few weeks after the operation, and no expansion in aneurysm diameter was noticed. A normal S/D ratio in the uterine arteries indicated increased blood flow in the uterine arteries. A healthy female was born. Pregnant patients with coarctation of the aorta should have surgical correction preferably in the first or second trimesters.
Authors:
M J Kupferminc; J B Lessing; A Jaffa; B A Vidne; M R Peyser
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  72     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-08-12     Completed Date:  1993-08-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  398-402     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology 'A', Tel Aviv Sourasky Medical Center, Hakirya Maternity Hospital, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aorta, Thoracic
Aortic Aneurysm, Thoracic / complications,  diagnosis,  physiopathology*,  surgery
Aortic Coarctation / complications,  diagnosis,  physiopathology*,  surgery
Blood Flow Velocity
Female
Fetus / blood supply*
Humans
Hypertension / etiology
Infant, Newborn
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis,  physiopathology*,  surgery
Rheology
Umbilical Arteries / physiopathology*
Uterus / blood supply,  physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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