Antepartum acute Stanford type A aortic dissection: a case report and literature review

Background Aortic dissection in pregnancy is a life-threatening event that is associated with high maternal and foetal mortality. Most cases occur during the third trimester of pregnancy, Herein, we describe a case of a pregnant woman with acute type A aortic dissection at 28 weeks of gestation. Case presentation A previously healthy, 24-year-old gravida 2 para 1 woman was brought to the emergency department during at the 28 weeks of gestation and diagnosed with acute type A aortic dissection. Cesarean section was performed with the cardiac surgical team on standby for cardiopulmonary bypass and the patient delivered a baby weighing 1000 g. After the operation, we performed the Beatall procedure and total arch replacement with FET using the deep hypothermic circulatory arrest technique. Both the mother and child survived and recovered well. A review of the literature on antepartum acute aortic dissection during pregnancy is also presented. Conclusion Women should have a comprehensive, systematic physical examination before getting pregnant. Women at high risks of aortic dissection must undergo multidisciplinary evaluation and be counseled before pregnancy, once they become pregnant, their consistent aortic root diameter should be consistently monitored, and their blood pressure strictly controlled.

Automated summary

This case report describes a pregnant woman diagnosed with acute type A aortic dissection at 28 weeks of gestation. With emergency surgery and the use of deep hypothermic circulatory arrest technique, both the mother and the baby survived. The article also includes a literature review on antepartum acute aortic dissection during pregnancy and highlights the importance of pre-pregnancy examinations and blood pressure monitoring during pregnancy to prevent this condition.