Aortic dissection during delivery by cesarean section

Baya Aziza,Samiha Cherif,Bouzid Abdelmalek

doi:10.48087/bjmscr.2019.6115

Abstract

Aortic dissection is unusual in young women, but when it occurs it is frequently associated with pregnancy and more importantly with pregnancy hypertension. A 37 old women with gestational hypertension was presented with chest pain during delivery by cesarean section and chest computed tomography scan was done and showed an aortic dissection; she was operated in an emergency with a successful outcome after delivery. Our aim is to put the point on the need to suspect the diagnosis of aortic dissection in a patient with preeclampsia and who complains of acute chest pain.

Highlights

Acute aortic dissection can occur with the connective tissue disorders and high blood pressure disorders during pregnancy, including preeclampsia, coarctation of aorta, and Marfan's syndrome (1)
We report a case of aortic dissection, which occurred during delivery by cesarean section in a woman with a gestational hypertension
In women aged less than 40 years, 50% of all aortic dissections are associated with pregnancy

Summary

Introduction

Acute aortic dissection can occur with the connective tissue disorders and high blood pressure disorders during pregnancy, including preeclampsia, coarctation of aorta, and Marfan's syndrome (1). In women aged less than 40 years, 50 % of all aortic dissections are associated with pregnancy (2). Systemic hypertension is the main risk factor and it has been reported in the literature review that deaths occurred by the rupturing of aortic dissection after a cesarean section in the patients who were with gestation’s hypertension. The main treatment of type I of De Bakey aortic dissection is surgical, but medical management of the hypertension must be undertaken. We report a case of aortic dissection, which occurred during delivery by cesarean section in a woman with a gestational hypertension.

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Discussion

Conclusion