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@article{Cauldwell:2019:10.1136/heartjnl-2019-314817,
author = {Cauldwell, M and Steer, PJ and Curtis, SL and Mohan, A and Dockree, S and Mackillop, L and Parry, HM and Oliver, J and Sterrenberg, M and Wallace, S and Malin, G and Partridge, G and Freeman, LJ and Bolger, AP and Siddiqui, F and Wilson, D and Simpson, M and Walker, N and Hodson, K and Thomas, K and Bredaki, F and Mercaldi, R and Walker, F and Johnson, MR},
doi = {10.1136/heartjnl-2019-314817},
journal = {Heart},
pages = {1725--1731},
title = {Maternal and fetal outcomes in pregnancies complicated by Marfan syndrome.},
url = {http://dx.doi.org/10.1136/heartjnl-2019-314817},
volume = {105},
year = {2019}
}

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TY  - JOUR
AB  - OBJECTIVES: Information to guide counselling and management for pregnancy in women with Marfan syndrome (MFS) is limited. We therefore conducted a UK multicentre study. METHODS: Retrospective observational study of women with MFS delivering between January 1998 and March 2018 in 12 UK centres reporting data on maternal and neonatal outcomes. RESULTS: In total, there were 258 pregnancies in 151 women with MFS (19 women had prior aortic root replacements), including 226 pregnancies ≥24 weeks (two sets of twins), 20 miscarriages and 12 pregnancy terminations. Excluding miscarriages and terminations, there were 221 live births in 139 women. Only 50% of women received preconception counselling. There were no deaths, but five women experienced aortic dissection (1.9%; one type A and four type B-one had a type B dissection at 12 weeks and subsequent termination of pregnancy). Five women required cardiac surgery postpartum. No predictors for aortic dissection could be identified. The babies of the 131 (65.8%) women taking beta-blockers were on average 316 g lighter (p<0.001). Caesarean section rates were high (50%), particularly in women with dilated aortic roots. In 55 women, echocardiographic aortic imaging was available prepregnancy and postpregnancy; there was a small but significant average increase in AoR size of 0.84 mm (Median follow-up 2.3 months) CONCLUSION: There were no maternal deaths, and the aortic dissection rate was 1.9% (mainly type B). There with no identifiable factors associated with aortic dissection in our cohort. Preconception counselling rates were low and need improvement. Aortic size measurements increased marginally following pregnancy.
AU  - Cauldwell,M
AU  - Steer,PJ
AU  - Curtis,SL
AU  - Mohan,A
AU  - Dockree,S
AU  - Mackillop,L
AU  - Parry,HM
AU  - Oliver,J
AU  - Sterrenberg,M
AU  - Wallace,S
AU  - Malin,G
AU  - Partridge,G
AU  - Freeman,LJ
AU  - Bolger,AP
AU  - Siddiqui,F
AU  - Wilson,D
AU  - Simpson,M
AU  - Walker,N
AU  - Hodson,K
AU  - Thomas,K
AU  - Bredaki,F
AU  - Mercaldi,R
AU  - Walker,F
AU  - Johnson,MR
DO  - 10.1136/heartjnl-2019-314817
EP  - 1731
PY  - 2019///
SN  - 1355-6037
SP  - 1725
TI  - Maternal and fetal outcomes in pregnancies complicated by Marfan syndrome.
T2  - Heart
UR  - http://dx.doi.org/10.1136/heartjnl-2019-314817
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31129614
UR  - https://heart.bmj.com/content/early/2019/05/24/heartjnl-2019-314817
UR  - http://hdl.handle.net/10044/1/71452
VL  - 105
ER  -

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