Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Extract

Thank you for the opportunity to respond to the comment from Hager and co-workers. It is an immense tragedy when a young woman dies during pregnancy. We agree with Hager and co-workers that there is no definite safe aortic root diameter for women with Marfan syndrome to get pregnant. Dissections may occur at normal aortic diameters in patients with Marfan syndrome. Should we therefore advise all women with Marfan syndrome against pregnancy? During recent years, a panel of international experts has reached consensus that pregnancy can be tolerated in women with Marfan syndrome with a slightly dilated aortic root.1 This expert consensus is being validated by our findings, which indicate that pregnancy is relatively safe in women with Marfan syndrome and an aortic root diameter up to 45 mm.2 However, women with a previous dissection should not get pregnant. We agree with Hager et al. that all patients with Marfan syndrome deserve close and careful monitoring before, during, and after pregnancy. Before pregnancy, all women should undergo a magnetic resonance angiogram to investigate if there is dilatation in other parts of the aorta. Also, frequent echocardiographic imaging should be performed throughout pregnancy and the postpartum period to check for progressive aortic dilatation. In the future other risk factors for aortic dissection, such as aortic elasticity, might become available to identify high-risk patients for aortic dissection during pregnancy.3

Issue Section:
Letters to the Editor
You do not currently have access to this article.
Download all slides