Coarctation of the aorta: outcome of pregnancy

J Am Coll Cardiol. 2001 Nov 15;38(6):1728-33. doi: 10.1016/s0735-1097(01)01617-5.


Objectives: The study sought to determine the outcome of pregnancy in women with coarctation of the thoracic aorta.

Background: Patients with coarctation of the thoracic aorta are expected to reach childbearing age, but data on the outcome of pregnancy in this population are limited.

Methods: The Mayo Clinic database was reviewed for women of childbearing age (> or =16 years old) with a diagnosis of aortic coarctation evaluated from 1980 to 2000. Spectrum of cardiovascular disease, surgical history, and obstetrical and neonatal outcomes were determined.

Results: Fifty women with coarctation had pregnancies: 30 had coarctation repair before pregnancy, 10 had repair after pregnancy, 4 had repair both before and after pregnancy, and 6 had no history of repair. The 50 women had 118 pregnancies resulting in 106 births. There were 11 miscarriages (9%), 4 premature deliveries (3%), and 1 early neonatal death; 38 deliveries (36%) were by cesarean section. Of the 109 offspring, 4 (4%) had congenital heart disease. A patient with Turner syndrome died of a Stanford type A dissection at 36 weeks of pregnancy. Nineteen women (38%) were known to have hemodynamically significant coarctation during pregnancy (gradient > or =20 mm Hg). Fifteen women (30%) had hypertension during their pregnancy, 11 of whom (73%) had hemodynamically significant coarctation during that time (8 with native and 3 with residual/recurrent coarctation).

Conclusions: Major cardiovascular complications were infrequent but continue to be a source of concern for patients with coarctation who become pregnant. Systemic hypertension during pregnancy was common and related to the presence of a significant coarctation gradient.

MeSH terms

  • Adolescent
  • Adult
  • Aorta, Thoracic
  • Aortic Coarctation / complications*
  • Aortic Coarctation / surgery
  • Female
  • Humans
  • Hypertension / complications
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications, Cardiovascular
  • Pregnancy Outcome*
  • Statistics, Nonparametric