Fatal, spontaneous, unknown aortal aneurysm dissection in a woman of 38 weeks’ gestation

We describe a case of spontaneous dissection of an unknown ascending

thoracic aortic aneurysm in a 35year-old woman in her 38th week of pregnancy, resulting in an atypical clinical picture, emergency caesarean section, and lethal outcome in both the mother and child.

aortic dissection, pregnancy, caesarean section, perinatal death

1. Lapinsky SE, Kruczynski K, Slutsky AS. Critical Care in the Pregnant Patient. Am J Respir Crit Care Med 1995;152:427-55.

2. Townend JN, Davies MK, Jones EL. Fatal rupture of an unsuspected post-traumatic aneurysm of the thoracic aorta during pregnancy. Br Heart J 1991;66(3):248-9.

3. Nasiell J, Norman M, Lindqvist PG, Malmstedt J, Bottinga R, Blennow R. Aortic dissection in pregnancy: a life-threatening disease and a diagnosis of worth considering. Acta Obstet Gynecol Scand 2009;88(10):1167-70.

4. Beirer M, Banke IJ, Münzel D, Wendorff H, Khaladj N, Kirchhoff

C, Huber-Wagner S, Biberthaler P. Emergency cesarean section due to acute aortic dissection type A (Debakey I) without Marfan syndrome: a case report and review of the literature. J Emerg Med 2014;46(1)13-7.

5. Erbel R, Oelert H, MeyerJ, Puth M, Mohr-Katoly S, Hausmann D, et al. Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Implications for prognosis and therapy. The European Cooperative Study Group on Echocardiography. Circulation 1993;87:1604–15.

6. Gilon D, Mehta RH, Oh JK, Januzzi JL Jr., Bossone E, Cooper JV, et al. Characteristics and in-hospital outcomes of patients with cardiac tamponade complicating typeAacute aortic dissection. Am J Cardiol 2009;103:1029–31.

7. Monrozies M, Bouissou H, Grynfogel M. Fatal rupture of an

abdominal aortic aneurysm during pregnancy. Bull Fed Soc Gynecol Obstet Lang Fr 1962;14:791-5.

8. Hunsaker DM, Turner S, Hunsaker JC 3rd. Sudden and unexpected death resulting from splenic artery aneurysm rupture: two case reports of pregnancy-related fatal rupture of splenic artery aneurysm. Am J Forensic Med Pathol 2002;23(4):338-41.

9. Barrett JM, Van Hooydonk JE, Boehm FH. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982;37:557-66.

10. Sutinen S, Piiroinen O. Marfan syndrome, pregnancy,

and fatal dissection of aorta. Acta Obstet Gynecol Scand 1971;50(3):295-300.

11. Pánczél Z, Sára L, Tóth P, Hubay M, Keller E, Langmár Z, Pajor A. Spontaneous aortic rupture during pregnancy. Orv

Hetil 2011;152(23):929-33.

12. Ichigo S, Sugiyama M, Murase T, Ikeda T, Imai A.An autopsy case of acute aortic dissection during postpartum period. Clin Exp Obstet Gynecol 2013;40(3):435-6.

13. Monteiro FN, Bhagavath P, Rao L, Pai ND, Kanchan T, Menezes RG, et al. Descending thoracic aortic aneurysm rupture during postpartum period. J Forensic Sci 2011;56(4):1054-7.

14. Snir E, Levinsky L, Salomon J, Findler M, Levy MJ, Vidne BA.Dissecting aortic aneurysm in pregnant women without Marfan disease.Surg Gynecol Obstet 1988;167(6):463-5.