Significant infrarenal aortic stenosis in pregnancy: a case report

Edmund Yin Man Chung,Anushree Tiku,Amanda Mather,Sean Seeho

doi:10.1186/s13256-019-2057-0

Abstract

BackgroundHypertension is common in pregnant women presenting with aortic coarctation or Takayasu’s arteritis. Uncontrolled hypertension leads to increased adverse maternal and neonatal events.Case presentationA 36-year-old gravida 2, para 1 Caucasian woman presented at 9 weeks of gestation with headaches but normal blood pressure. She had a past medical history of an in vitro fertilization pregnancy complicated by preeclampsia at 27 weeks of gestation (birth weight 1900 g) and infrarenal aortic stenosis. In the current pregnancy, she received aspirin and calcium as preeclampsia prophylaxis, remained normotensive throughout pregnancy, and was delivered by elective cesarean section at 37 weeks without complications.ConclusionsThis case demonstrates a significant chronic aortopathy in pregnancy with normal fetal growth and uterine blood flow through collateral supply from the internal mammary and epigastric arteries.

Highlights

Hypertension is common in pregnant women presenting with aortic coarctation or Takayasu’s arteritis
* Correspondence: yinmanchung@gmail.com 1Renal Department, Royal North Shore Hospital, St Leonards, Australia 2Northern Clinical School, The University of Sydney, Camperdown, Australia Full list of author information is available at the end of the article patient with an uncomplicated second pregnancy in the setting of significant infrarenal aortic stenosis, and we review the literature on interventions for aortopathies in pregnancy
Abdominal aortic coarctation presents a significant risk of hypertension and aortic dissection in pregnancy

Summary

Introduction

Hypertension is common in pregnant women presenting with aortic coarctation or Takayasu’s arteritis. * Correspondence: yinmanchung@gmail.com 1Renal Department, Royal North Shore Hospital, St Leonards, Australia 2Northern Clinical School, The University of Sydney, Camperdown, Australia Full list of author information is available at the end of the article patient with an uncomplicated second pregnancy in the setting of significant infrarenal aortic stenosis, and we review the literature on interventions for aortopathies in pregnancy. In the absence of a clinical history or signs of neurofibromatosis, tuberculosis, or radiation exposure, as well as little evidence of active inflammation, the diagnosis of chronic abdominal aortopathy from congenital abdominal aortic coarctation, fibromuscular dysplasia, or inactive Takayasu’s arteritis was made.

Results

Conclusion