Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Introduction: Turner syndrome (TS) is a genetic disorder linked to the total or partial absence of an X chromosome. Pregnancies in women with TS are high-risk pregnancies due to the risk of aortic dissection. A national multidisciplinary meeting, ‘Turner, heart and pregnancy’, has been set up in 2019. Its main goal is to assess the files of women with ST who wish to become pregnant, in order to authorize or not the pregnancy. Patients and Method: This is a multicentre cohort study. Women with ST presented during the multidisciplinary meeting, between 2019 and 2024, were included. Data collected included karyotype, age at diagnosis of ST, mode of conception, pregnancy outcome and complications as well as the mode of delivery. Aortic diameters were compared before and after pregnancy. Dilation’s definition is a crude aortic diameter greater than 30 mm or indexed to size greater than 20 mm/m. Results: One hundred and thirty-three women were included with a total of 79 pregnancies (28 natural pregnancies and 51 obtained after oocyte donation), among 44 women. The number of spontaneous miscarriages was 32/79 (40%). Forty children were born alive, and pregnancies are still ongoing. The main complications observed were arterial hypertension (20% of pregnancies), pre-eclampsia (12.5%), gestational diabetes (12.5%) and gestational cholestasis (7.5%). The caesarean delivery rate was 59%. No serious cardiovascular events occurred. A comparison of aortic diameters (n=18 patients) before and after pregnancy was not statistically significant. For crude diameter, the median change was 0 mm [-0.75-1.75] (p=0.69). Conclusion: Our study confirms that pregnancies in women with ST have a high rate of miscarriages, hypertension and pre-eclampsia. Although our data suggest that aortic diameters are not significantly increased during pregnancy, a preconception consultation is necessary in all women with ST who wish to become pregnant.
Source: HAL
Author: Bonnaudet, Morgane
Institution: Université des Antilles
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7080349776