In a case of severe coarctation of the aorta diagnosed during pregnancy, termination was necessitated due to refractory hypertension, leading to successful subsequent pregnancies.
Coarctation of the aorta is a rare but important cause of refractory hypertension in pregnancy that may require pregnancy interruption and percutaneous intervention to allow for future safe pregnancies.
Absolute Event Rate: 0% vs 0%
Abstract Background Coarctation of the aorta (CoA) is a well-known congenital heart disease, which is often associated with other cardiac and vascular anomalies, most frequently bicuspid aortic valve. Aortic coarctation is an unusual cause of hypertension during pregnancy and its management is not clarified. Case summary We report a case of a 24-year-old pregnant woman with long standing hypertension, that presented at the end of the first trimester with severe refractory hypertension. The diagnostic investigation culminated in the diagnosis of a CoA. Facing risks for pursuing pregnancy such as aortic complications, hypertensive disorders, and fetal adverse outcomes aside from limited therapeutic options and having in count the relatively early stage in pregnancy, it was decided by multidisciplinary team and the patient for pregnancy interruption. After that, patient was treated by percutaneous dilatation of aortic coartation with stent implantation with good results. Recently, the patient was able to carry out a newly full-term pregnancy without major incidents. Conclusion Coarctation of the aorta should be considered in pregnant women with refractory hypertension. It is associated to considerable risks to the mother and to the fetus. In cases presenting with refractory severe hypertension, termination of pregnancy needs to be considered, especially in first trimester pregnancies. This case also highlights to the importance of investigating secondary causes of hypertension in young people, as these can often be treated, averting potentially severe complications.
Sá et al. (Thu,) reported a other. In a case of severe coarctation of the aorta diagnosed during pregnancy, termination was necessitated due to refractory hypertension, leading to successful subsequent pregnancies.