Multidisciplinary management involving medical therapy, planned early delivery, and staged percutaneous and surgical interventions can lead to successful maternal and fetal outcomes in high-risk pregnancies with Turner syndrome and complex aortic pathology.
May support multidisciplinary strategies in rare Turner pregnancies with aortopathy; leaves open generalizability beyond single cases.
A 30‑year‑old woman with Turner Syndrome was admitted to our centre in 12th week of her first pregnancy with a history o surgical correction of coarctation of aorta. She was asymptomatic with good general condition. Transthoracic echocardiography revealed a bicuspid aortic valve with moderate regurgitation and an ascending aorta aneurysm. In angio‑MR the narrowing of the isthmus of the aorta over 50% was seen with peak systolic gradient found in echocardiography approximately 41 mmHg. She was prescribed metoprolol and was closely monitored, the course of pregnancy was uneventful. In 24th week of pregnancy steroids were administered as a preparation for earlier delivery. She delivered in 34th week of pregnancy a healthy baby weighting 2100 grams. Caesarean section was performed in the cardiothoracic surgery ward and after delivery she underwent percutaneous angioplasty of coarctation of aorta with stent implantation. Six weeks after labour she underwent the Bental de Bono procedure with artificial aortic valve implantation. In six‑month observation patient was in good general condition, echocardiography showed normal ascending aorta diameter. JRCD 2013; 1 (4): 16–20
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Tomkiewicz−Pająk et al. (2013) studied this question.
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