米国マルファン症候群患者団体The Marfan Foundationからの情報を中心に、マルファン症候群や関連疾患についての海外情報を翻訳して発信します。

大動脈解離の治療における進展 ~B型解離と妊娠・出産~

Advances in the Treatment of Aortic Dissection




What about pregnancy? This is a very common question and we presume that these females who are pregnant are at a higher risk due to the physiologic changes. The heart has to work harder so that, you know, that baseball is being thrown harder when the aorta plays catch with it. There's a higher rate of cardiac output as well so there's more blood flowing to support the growing and developing fetus.



And type B dissection rates range in the literature anywhere from 1.4 to about 3 percent and the one risk factor is a prenatal aortic diameter of greater than 40 millimeters or 4 centimeters is associated with an increased risk of developing a dissection during your pregnancy. 



When is the risk the highest really during the third trimester and we talked about a lot of the physiologic changes driving some of the risk and those changes don't immediately stop with delivery and so they're the second highest phase of risk is actually in the immediate post-delivery period up to about a month afterwards and so it's really critical that patients are closely monitored by both a cardiologist as well as someone with a an experience in maternal-fetal medicine, managing patients with a connective tissue disorder.



Beta blockade has essentially been a standard therapy. Into Dr. Moon's point it does save lives. It has been associated with lower birth weights during pregnancy and then subsequent delivery but it hasn't been shown to have any out, long-term outcome effects on the child after their exposure so there's some change in guidelines and we saw de-emphasized a little bit in the European society guidelines in 2018 but I think in the right context and following with experienced cardiologists and maternal-fetal medicine specialists they play an integral role in managing probably one of the highest risk parts of a woman's life with a connective tissue disorder.



The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.

The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。