Loeys-Dietz syndrome and pregnancy: The first ten years

Int J Cardiol. 2017 Jan 1:226:21-25. doi: 10.1016/j.ijcard.2016.10.024. Epub 2016 Oct 11.

Abstract

The physiological and haemodynamic changes that occur in pregnancy and the postpartum period increase the risk of aortic dissection. Loeys-Dietz syndrome results from mutations in the genes encoding components of the TGF-β signalling pathway; aortic pathology is of particular concern in this condition but other vascular abnormalities can also be present. Significant maternal morbidity and mortality has been described in patients with Loeys-Dietz syndrome, but successful and uncomplicated pregnancies are still possible. Nevertheless, all patients with this condition should, at present, be treated as very high risk in pregnancy and the postpartum period, until reliable risk prediction tools become available. This review summarises the recent advances in the understanding of the pathophysiology of this condition, and the management strategies currently advocated.

Keywords: Aortic dissection; High-risk pregnancy; Loeys-Dietz syndrome.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm / epidemiology
  • Aortic Aneurysm / physiopathology*
  • Aortic Aneurysm / prevention & control
  • Aortic Dissection / epidemiology
  • Aortic Dissection / physiopathology*
  • Aortic Dissection / prevention & control
  • Female
  • Humans
  • Loeys-Dietz Syndrome / epidemiology
  • Loeys-Dietz Syndrome / physiopathology*
  • Loeys-Dietz Syndrome / therapy*
  • Pregnancy
  • Pregnancy, High-Risk / physiology*
  • Prenatal Care / methods
  • Prenatal Care / trends*
  • Time Factors