{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:30:14Z","timestamp":1788953414719,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pregnancy complicated with type B aortic dissection is a rare but devastating condition. Guidelines for managing this condition are lacking. We present our observation and experiences in managing five pregnant women with complicated type B aortic dissection in the second or third trimesters, aiming to gain insights that can aid in proposing an appropriate management strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Zhongnan Hospital of Wuhan University.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Pregnant women with complicated type B aortic dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical data of five pregnant women with complicated type B aortic dissection admitted to Zhongnan Hospital of Wuhan University from January 2022 to June 2023 were collected. The clinical characteristics, treatment strategies, and corresponding maternal and infant outcomes were retrospectively analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Survival of mothers and foetuses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All five study participants were diagnosed with complicated type B aortic dissection by computed tomography angiography (CTA). The range of gestational weeks at admission was 27\u2009weeks\u2009+\u20093\u2009days to 36\u2009weeks\u2009+\u20096\u2009days. The first patient, planning a caesarean section (C\u2010section) followed by thoracic endovascular aortic repair (TEVAR), died of aortic dissection rupture during C\u2010section. Her neonate was successfully rescued. In contrast, the remaining four patients who underwent TEVAR first survived. Among them, three patients underwent single\u2010stage aortic repair and delivery, while one patient received C\u2010section\u00a031\u2009days after TEVAR. Three preterm live births were recorded among these surviving mothers. Neonatal death occurred in one case with a gestational age of 29\u2009weeks\u2009+\u20095\u2009days, who had foetal distress before surgery. During the follow\u2010up period of up to 3\u2009months, no maternal or infant death occurred. No device\u2010related or systemic complications were observed in the surviving mothers after discharge. Routine physical examinations of the four live births showed no abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For pregnant women with thoracic back pain and high suspicion of aortic dissection, CTA should be conducted promptly to prevent missed or delayed diagnosis. Maternal survival should be prioritised over foetal outcome once diagnosed. TEVAR was demonstrated to be safe and feasible for such patients. For women with complicated type B aortic dissection in late pregnancy, TEVAR followed by C\u2010section may be a promising treatment strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17923","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T02:34:15Z","timestamp":1722306855000},"page":"1874-1881","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Management and outcomes of aortic dissection type B in late pregnancy: A retrospective case series"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5372-3830","authenticated-orcid":false,"given":"Zhen","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Obstetrics Zhongnan Hospital of Wuhan University  Wuhan Hubei China"},{"name":"Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuechen","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Zhongnan Hospital of Wuhan University  Wuhan Hubei China"},{"name":"Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province  Wuhan Hubei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Zhongnan Hospital of Wuhan University  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Zhongnan Hospital of Wuhan University  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Zhongnan Hospital of Wuhan University  Wuhan Hubei China"},{"name":"Clinical Medicine Research Centre of Prenatal Diagnosis and Birth Health in Hubei Province  Wuhan Hubei 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