Korean J Obstet Gynecol.  2011 Nov;54(11):696-700. 10.5468/KJOG.2011.54.11.696.

Unexpected acute aortic dissection after elective cesarean section delivery: Report of a case and review of the literature

• Kang BH
• Lee MA
• Rhee YE
• Noh HT

• KMID: 2274109
• DOI: http://doi.org/10.5468/KJOG.2011.54.11.696

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 difficult 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.

Keyword

Aortic dissection; Pregnancy

MeSH Terms

Cesarean Section
Chest Pain
Connective Tissue
Female
Humans
Hypertension
Postpartum Period
Pregnancy
Pregnancy Trimester, Third
Prognosis
Risk Factors

Figure

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  Fig. 1 Chest X-ray showed normal finding.

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  Fig. 2 (A) Contrast enhanced computed tomography angiographic scan showed double-lumen proximal descending thoracic aorta with intimal flap separating the true lumen from false lumen. (B) Contrast enhanced computed tomography angiographic scan (sagittal section) showed type III aortic dissection.

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