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Pregnancy-associated aortopathy and sudden postpartum death
A 39-year-old woman who had undergone an uncomplicated elective cesarean section for a low-lying placenta collapsed and died the following day. At autopsy, there was dissection of an aneurysmally-dilated thoracic aorta with 400 mls of fluid and clotted blood in the pericardial sac. There were no fea...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328850/ https://www.ncbi.nlm.nih.gov/pubmed/37020086 http://dx.doi.org/10.1007/s12024-023-00606-5 |
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author | Byard, Roger W |
author_facet | Byard, Roger W |
author_sort | Byard, Roger W |
collection | PubMed |
description | A 39-year-old woman who had undergone an uncomplicated elective cesarean section for a low-lying placenta collapsed and died the following day. At autopsy, there was dissection of an aneurysmally-dilated thoracic aorta with 400 mls of fluid and clotted blood in the pericardial sac. There were no features of Marfan syndrome or other connective tissue disorders. Histology revealed thinning of the aortic wall with fragmentation of elastic fibers and no inflammation. Vessels elsewhere were normal. This case demonstrates a rare complication of pregnancy that may not present until after delivery with unexpected collapse and sudden death. Predisposing factors include an increased cardiac output, reduction in systemic vascular resistance, an increase in left ventricular muscle mass, and alterations in serum progesterone and estrogen levels which may cause structural changes to the aortic wall. The possibility of syndromic and familial connective tissue disorders should also be considered. |
format | Online Article Text |
id | pubmed-10328850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-103288502023-07-09 Pregnancy-associated aortopathy and sudden postpartum death Byard, Roger W Forensic Sci Med Pathol Images in Forensics A 39-year-old woman who had undergone an uncomplicated elective cesarean section for a low-lying placenta collapsed and died the following day. At autopsy, there was dissection of an aneurysmally-dilated thoracic aorta with 400 mls of fluid and clotted blood in the pericardial sac. There were no features of Marfan syndrome or other connective tissue disorders. Histology revealed thinning of the aortic wall with fragmentation of elastic fibers and no inflammation. Vessels elsewhere were normal. This case demonstrates a rare complication of pregnancy that may not present until after delivery with unexpected collapse and sudden death. Predisposing factors include an increased cardiac output, reduction in systemic vascular resistance, an increase in left ventricular muscle mass, and alterations in serum progesterone and estrogen levels which may cause structural changes to the aortic wall. The possibility of syndromic and familial connective tissue disorders should also be considered. Springer US 2023-04-05 2023 /pmc/articles/PMC10328850/ /pubmed/37020086 http://dx.doi.org/10.1007/s12024-023-00606-5 Text en © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Images in Forensics Byard, Roger W Pregnancy-associated aortopathy and sudden postpartum death |
title | Pregnancy-associated aortopathy and sudden postpartum death |
title_full | Pregnancy-associated aortopathy and sudden postpartum death |
title_fullStr | Pregnancy-associated aortopathy and sudden postpartum death |
title_full_unstemmed | Pregnancy-associated aortopathy and sudden postpartum death |
title_short | Pregnancy-associated aortopathy and sudden postpartum death |
title_sort | pregnancy-associated aortopathy and sudden postpartum death |
topic | Images in Forensics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10328850/ https://www.ncbi.nlm.nih.gov/pubmed/37020086 http://dx.doi.org/10.1007/s12024-023-00606-5 |
work_keys_str_mv | AT byardrogerw pregnancyassociatedaortopathyandsuddenpostpartumdeath |