Due to ascertainment bias, prepartum lack of knowledge of diagnosis and inadequate peripartum imaging data, the risk of pregnancy-associated vascular complications in MFS is not clear.
This study evaluated a single- center experience of 169 women with MFS to describe these complications.
In never vs ever-pregnant MFS women, clinical, imaging and pregnancy history were compared. Pregnancy associated vascular complications were described.
A total of 112 live births were observed in 74 ever-pregnant women. In never-pregnant women, elective aortic root replacement took place at a younger age (33 years vs 42 years; P= 0.0026). Even though the prevalence of aortic dissection did not differ between never-pregnant vs ever-pregnant women (23% vs 31%; P=0.25), it was most likely to occur at an earlier age in the never pregnant group (38 years vs 45 years; P = 0.07). The mean pregnancy-related aortic diameters were stable of the observed “sanctioned” pregnancies with pre-delivery diameters ≤ 4.5 cm. A total of 5 dissections were associated with pregnancy. In women unaware of their diagnosis, 2 type A were present. In women aware of their diagnosis, 2 type B and 1 isolated coronary artery dissection were present. Therefore, the dissection rates were 5-hold greater in the pregnancy period compared to the nonpregnancy period.
In only patients not aware of their diagnosis, pregnancy-related type A diagnosis occurred. Type B dissection remains to be an uncertain complication. Even though there were baseline differences between the never- and ever- pregnant groups, there was no difference in the dissection risk observed outside the peripartum period. Women with prepartum aortic diameters between 4.0 and 4.5 cm showed stable aortic dimensions during the pregnancy period.