Question

Discuss management and long term follow-up of:
Coarctation and pregnancy. [3]

Hint:

Managing blood pressure and monitoring for complications is crucial for pregnant women with coarctation of the aorta.

Answer 1

Step 1: Risks of Coarctation in Pregnancy:
1. Hypertension: Coarctation of the aorta can lead to severe pregnancy-related hypertension, including preeclampsia, which can complicate both the pregnancy and delivery.
2. Preterm Delivery: The increased cardiovascular strain may lead to preterm labor and delivery due to fetal distress.
3. Aneurysm Rupture: The pressure overload can increase the risk of aortic dissection or aneurysm rupture, which can be life-threatening.
Step 2: Management During Pregnancy:
1. Pre-conception Counseling: It is crucial for women with coarctation to receive pre-conception counseling to assess the risks and plan the pregnancy.
2. Blood Pressure Control: Tight control of blood pressure is essential throughout the pregnancy. Antihypertensive medications should be used carefully to avoid harm to the fetus.
3. Monitoring: Close monitoring of maternal and fetal well-being is necessary, including frequent blood pressure checks, echocardiograms, and ultrasounds to assess fetal growth.