Valeria E Duarte, Jessica N Richardson, Michael N Singh
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引用次数: 0
摘要
胸主动脉疾病(TAD)在妊娠期间具有很大的风险,尤其是对于患有遗传性疾病(如马凡综合征、洛伊-迪茨综合征和血管性埃勒斯-丹洛斯综合征)的妇女。本综述探讨了妊娠期 TAD 的流行病学、风险评估和管理。考虑到 TAD 的遗传性和潜在的妊娠相关并发症,孕前咨询至关重要。基因检测和影像监测有助于风险评估。医疗管理,包括β-受体阻滞剂和严格的血压控制,在整个孕期都至关重要。在某些情况下,可能需要进行手术干预。心脏科医生、产科医生、心脏外科医生、麻醉科医生和其他具有心脏产科专业知识的专家共同参与的多学科方法对于取得最佳治疗效果至关重要。患者教育和共同决策在应对复杂的妊娠 TAD 以及改善孕产妇和新生儿预后方面发挥着至关重要的作用。
The Impact of Pregnancy in Patients with Thoracic Aortic Disease: Epidemiology, Risk Assessment, and Management Considerations.
Thoracic aortic disease (TAD) poses substantial risks during pregnancy, particularly for women with genetic conditions such as Marfan syndrome, Loeys-Dietz syndrome, and vascular Ehlers-Danlos syndrome. This review examines the epidemiology, risk assessment, and management of TAD in pregnancy. Preconception counseling is vital considering the hereditary nature of TAD and potential pregnancy-related complications. Genetic testing and imaging surveillance aid in risk assessment. Medical management, including beta-blockade and strict blood pressure control, is essential throughout pregnancy. Surgical interventions may be necessary in certain cases. A multidisciplinary approach involving cardiologists, obstetricians, cardiac surgeons, anesthesiologists, and other specialists with expertise in cardio-obstetrics is essential for optimal outcomes. Patient education and shared decision-making play vital roles in navigating the complexities of TAD in pregnancy and improving maternal and neonatal outcomes.