Document Detail


Obstetric and gynecologic complications in women with Marfan syndrome.
MedLine Citation:
PMID:  14562639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze the maternal and fetal outcomes of pregnancy and gynecologic problems in women with Marfan syndrome. STUDY DESIGN: The outcomes of 14 pregnancies in 4 women with Marfan syndrome were prospectively observed between January 1988 and December 2000. The cardiovascular and obstetric complications were analyzed. During pregnancy all the patients were carefully monitored with serial echocardiography and close attention to symptoms. RESULTS: Of the 14 pregnancies, 5 (35.7%) ended in abortion, and 3 of them occurred in the early second trimester due to cervical incompetence. Premature onset of labor occurred in 2 pregnancies at 31 and 34 weeks. Postpartum hemorrhage complicated 3 deliveries, and inversion of the uterus occurred in 1 patient. Significant cardiovascular complications occurred in 2 patients, who required surgical correction of the aortic aneurysm and replacement of the aortic valve. In one patient the operation was performed within hours of vaginal delivery, and the other patient underwent surgery 8 weeks postpartum. No maternal death occurred in the study. One infant in the series was diagnosed as having Marfan syndrome. A premature infant delivered at 31 weeks died on the second day of life. CONCLUSION: Women with Marfan syndrome are at high risk of aortic dissection in pregnancy even in the absence of preconceptional aortic root dilatation. Obstetric complications in patients with this condition have been underreported in the past. Women with aortic root dilatation of < 40 mm usually tolerate pregnancy well, with good maternal and fetal outcomes. Women with Marfan syndrome should be counseled regarding the risk of pregnancy to both mother and fetus. Patients who have cardiac decompensation or aortic dilatation > 40 mm are advised to avoid pregnancy.
Authors:
Jessica Rahman; Farooq Z Rahman; Waheeda Rahman; Suleiman A al-Suleiman; Mohammad Sayedur Rahman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  48     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-10-17     Completed Date:  2004-01-23     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  723-8     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, College of Medicine, King Faisal University, Dammam, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / etiology
Adult
Aortic Aneurysm / complications,  surgery
Aortic Diseases / complications,  ultrasonography
Aortic Valve / surgery
Female
Gestational Age
Humans
Marfan Syndrome / complications*
Obstetric Labor, Premature / complications
Postpartum Hemorrhage / complications
Pregnancy
Pregnancy Complications*
Pregnancy Outcome*
Prospective Studies
Ultrasonography, Prenatal
Uterine Cervical Incompetence / complications

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


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