Careful cardiovascular screening and follow-up of women with Turner syndrome before and during pregnancy is necessary to prevent maternal mortality
Received 28 July 2008; received in revised form 4 September 2008; accepted 6 September 2008. published online 06 November 2008.
Objective
To report the fatal outcome of a woman with Turner syndrome (TS) undergoing assisted reproductive technology (ART).
Design
Case report.
Setting
Reproductive medicine center.
Patient(s)
A 33-year-old woman with TS.
Intervention(s)
Screening before oocyte donation and treatment of aortic dissection occurring at term pregnancy.
Main Outcome Measure(s)
Evaluation of cardiovascular risk.
Result(s)
After a normal cardiac screening, a woman with TS got pregnant as a result of oocyte donation. At 16 weeks of gestation, a bicuspid aortic valve was detected and associated with moderate aortic root dilation. Aortic dissection was diagnosed at 38 weeks of gestation, which required emergent cesarean delivery and aortic root replacement. Despite surgical treatment, early maternal death was recorded.
Conclusion(s)
Careful cardiac screening and close follow-up before and during pregnancy are necessary in patients with TS.
aLaboratoire de Biologie de la Reproduction-CECOS, Groupe Hospitalier Cochin- Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
bService de Médecine de la Reproduction, Groupe Hospitalier Cochin- Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
cDépartement d'Anesthésie Réanimation, Groupe Hospitalier Cochin- Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
dMaternité Port Royal, Groupe Hospitalier Cochin- Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
eService de Cardiologie, Groupe Hospitalier Cochin- Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Université René Descartes, Paris, France
Reprint requests: Celine Chalas Boissonnas, M.D., Hopital Cochin, Service de Biologie de la Reproduction, 123 Boulevard de Port Royal, 75014 Paris, France (FAX: 33158411565).
C.C.B. has nothing to disclose. C.D. has nothing to disclose. M.B. has nothing to disclose. L.A. has nothing to disclose. C.M. has nothing to disclose. V.T. has nothing to disclose. A.M. has nothing to disclose. P.J. has nothing to disclose.
ABSTRACT