Pregnancy in women with Turner syndrome carries a high risk of major complications (10%) and maternal death (3.5%), highlighting the critical need for pre-pregnancy cardiovascular screening for aortic abnormalities.
Reported risks warrant caution in Turner syndrome pregnancies; leaves open whether screening improves outcomes.
Spontaneous pregnancy is rare among women with Turner syndrome (TS) since primary ovarian failure occurs in childhood for most patients. Recently, assisted pregnancies with donated oocytes have been successful in terms of live births among women with TS, but dire maternal cardiovascular complications have been reported. This article analyzes published data on TS pregnancies from 1960 to 2010 in order to identify specific risk factors predicting complications, including spontaneous versus assisted conception, pre-existing hypertension and abnormalities of the aortic valve or arch. Based on published case reports, the overall risk for major pregnancy complications in TS women is approximately 10% and the risk of maternal death is approximately 3.5%. The major risk factor for maternal death is an underlying aortic arch or aortic valve abnormality, which in most cases is not detected prior to pregnancy, due to absent or inadequate cardiovascular screening.
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Hadnott et al. (2011) studied this question.
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