Pregnancy increases long term risk of aortic complications in Marfan Syndrome

Marfan Syndrome is a well known risk factor in pregnancy for aortic complications like dissection of aorta. Donnelly RT et al [The Immediate and Long-Term Impact of Pregnancy on Aortic Growth Rate and Mortality in Women With Marfan Syndrome. J Am Coll Cardiol. 2012;60(3):224-229] has reported the long term follow up data of around seventy women with Marfan Syndrome undergoing nearly two hundred pregnancies, of which one hundred and seventy resulted in live births. Ten percent had obstetrical complications and adverse fetal outcome occurred in thirteen percent. None of the women had aortic dissection or required cardiac surgery during pregnancy. But the long term prevalence of aortic dissection and elective aortic surgery was higher in women who had a prior pregnancy. Greater aortic diameter, greater increase in aortic size during pregnancy, increased number of pregnancies, absence of beta blocker use during pregnancy and absence of prospective pregnancy follow up were risk factors for adverse cardiac outcome in this study. Low incidence of aortic complications during pregnancy for women with aortic diameter less than 4.5 centimeters and Marfan syndrome was commented by the authors.