Abstract
Patients with aortic dissection during pregnancy and postpartum period
exhibit high mortality. At present, a complete overview of aortic
dissection during pregnancy and postpartum period is lacking. This
systematic review includes 80 reports published from 2000-2020,
comprising a total study population of 103 patients with aortic
dissection. It was suggested that Stanford Type A aortic dissection is
more likely to occur in the third trimester, while Stanford Type B is
more likely to occur within 12 weeks postpartum. The most common risk
factor was connective tissue disease, with no other known risk factors.
Mode of delivery has no significant effect on the type of postpartum
aortic dissection. Reduced maternal and fetal mortality was observed
when patients with Stanford Type A aortic dissection occurring after 28
gestational weeks underwent aortic replacement after cesarean section.
Patients with Stanford Type B aortic dissection were treated mainly with
medication and/or endovascular repair. Contemporary management of
patients during pregnancy and within 12 weeks postpartum requires
multidisciplinary cooperation and includes serial, non-invasive imaging,
biomarker testing, and genetic risk profiling for aortopathy. Early
diagnosis and accurate treatment are essential to reduce maternal and
fetal mortality.