UNEXPECTED ACUTE AORTIC DISSECTION AFTER ELECTIVE CESAREAN SECTION DELIVERY: REPORT OF A CASE AND REVIEW OF THE LITERATURE
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Acute aortic dissection may indeed be a rare complication of pregnancy, and the majority of aortic dissections usually occur during the third trimester of pregnancy. Most aortic dissections occur as a result of systemic hypertension or connective tissue disorders. Without any treatment, more than 50% of patients die within the initial 48 hours, and the 3-month mortality rate is as high as 90%. Because the pain in puerperal women is uncertain and diffi cult to discriminate from physiologic pain, the diagnosis of aortic dissection is complex and requires a high index of suspicion. We experienced a case of unexpected acute aortic dissection that occurred after elective cesarean section delivery in a young woman without any known risk factors. This case of aortic dissection was managed medically. In postpartum patients complaining of chest pain, the suspicion of aortic dissection is important for prompt diagnosis and better prognosis.
Abstract
Acute aortic dissection may indeed be a rare complication of pregnancy, and the majority of aortic dissections usually occur during the third trimester of pregnancy. Most aortic dissections occur as a result of systemic hypertension or connective tissue disorders. Without any treatment, more than 50% of patients die within the initial 48 hours, and the 3-month mortality rate is as high as 90%. Because the pain in puerperal women is uncertain and diffi cult to discriminate from physiologic pain, the diagnosis of aortic dissection is complex and requires a high index of suspicion. We experienced a case of unexpected acute aortic dissection that occurred after elective cesarean section delivery in a young woman without any known risk factors. This case of aortic dissection was managed medically. In postpartum patients complaining of chest pain, the suspicion of aortic dissection is important for prompt diagnosis and better prognosis.
참고문헌 (15)
- Burchell HB, "Aortic dissection (dissecting hematoma; dissecting aneurysm of the aorta)", Circulation, 12, pp.1068~1079 (1955)
- Oskoui R, "Aortic dissection in women < 40 years of age and the unimportance of pregnancy", Am J Cardiol, 73, pp.821~823 (1994)
- Immer FF, "Aortic dissection in pregnancy: analysis of risk factors and outcome", Ann Thorac Surg, 76, pp.309~314 (2003)
- Barrett JM, "Pregnancyrelated rupture of arterial aneurysms", Obstet Gynecol Surv, 37, pp.557~566 (1982)
- Ohlson L, "Effects of the pregnant uterus on the abdominal aorta and its branches", Acta Radiol Diagn (Stockh), 19, pp.369~376 (1978)
- Wheat MW, "Aortic dissection", pp.55~60 (1983), McGraw-Hill
- Leiberman JR, "Uterine artery estrogen receptors in the nonpregnant and pregnant guinea pig", Am J Obstet Gynecol, 163, pp.1685~1688 (1990)
- Manalo-Estrella P, "Histopathologic fi ndings in human aortic media associated with pregnancy", Arch Pathol, 83, pp.336~341 (1967)
- De Paepe A, "Revised diagnostic criteria for the Marfan syndrome", Am J Med Genet, 62, pp.417~426 (1996)
- DeSanctis RW, "Aortic dissection", N Engl J Med, 317, pp.1060~1067 (1987)
- Ergin MA, "Glenn’s thoracic and cardiovascular surgery. 5th ed", pp.1955~1961 (1991), Appleton & Lange
- Scott C, "Acute ascending aortic dissection during pregnancy", Am J Crit Care, 10, pp.430~433 (2001)
- Konishi Y, "Dissecting aneurysm during pregnancy and the puerperium", Jpn Circ J, 44, pp.726~733 (1980)
- Walker PJ, "Vascular surgery. 4th ed", pp.1087~1102 (1995), W.B. Saunders
- Rutherford RB, "Aortic and other arterial dissections associated with pregnancy", Semin Vasc Surg, 8, pp.299~305 (1995)