{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:46:53Z","timestamp":1782604013408,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to characterize the incidence and clinical significance of pregnancy\u2010related aortic dissection using a large\u2010scale survey in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A questionnaire requesting the detailed information included in the clinical charts of pregnancy\u2010related aortic dissection cases (without any personally identifying information) was designed between 2013 and 2017 and administered to 407 perinatal centers in Japan. The response rate was 70.5%. Seventeen cases of pregnancy\u2010related aortic dissection were identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Maternal death due to aortic dissection was observed in nine patients (56.2%) while seven survived (43.8%). Dissection occurred during the postpartum period in 10 cases (62.5%), the third trimester in 4 (25.0%), labor in 1 (6.2%), and the second trimester in 1 (6.2%). The most common underlying diseases were: Marfan syndrome (25.0%), Loeys\u2010Dietz syndrome (6.2%), hypertension (6.2%), and Takayasu aortitis (6.2%). Stanford type A aortic dissection was associated with maternal death during both pregnancy and the postpartum period. However, deceased patients showed lower rates of pre\u2010diagnosed connective tissue disease than did survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The mortality rate of aortic dissection that occurred during pregnancy or postnatal periods was more than 50%. Aortic dissection occurred more frequently in the postnatal period than during pregnancy, and less frequently in women previously diagnosed with connective tissue disease than in women without any medical history of aortic disorders. If symptoms suggestive of aortic dissection, such as severe back pain, are observed, even after the end of pregnancy, exhaustive diagnostic examinations should be carried out.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14657","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T02:31:24Z","timestamp":1611282684000},"page":"1265-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Aortic dissection during pregnancy and puerperium: A Japanese nationwide survey"],"prefix":"10.1111","volume":"47","author":[{"given":"Hiroaki","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Mie University School of Medicine  Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chizuko A.","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Cerebral and Cardiovascular 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