COARCTATION OF THE AORTA AND PREGNANCY - BASED UPON 3 CASES MONITOREDFOR 10 YEARS

Classically, coarctation of the aorta is poorly tolerated during pregn ancy or at least is associated with a risk of rupture of the aorta, ru pture of a cerebral aneurysm or, more rarely, cardiac failure or bacte rial infection [3, 18]. The authors turned their attention to this ass ociation of coarctation of the aorta and pregnancy in the light of 3 c ases of pregnancy brought to term in the Department of Cardiology of t he Ibn Rochd Teaching Hospital Group, Casablanca, Morocco. During a 10 year period, 20 patients were hospitalised in the department with coa rctation of the aorta. There were 10 women, 3 of them pregnant. The me an age of these women was 26, with a range of 24 to 30. All patients h ad a normal pregnancy, delivery and post-partum, with neither cardiova scular, renal nor cerebral complications. There were no maternal death s, ruptures of the aorta, cerebrovascular accidents, bacterial infecti ons nor myocardial failure. All the pregnancies were brought to term. One patient was delivered vaginally with the use of forceps after full dilatation facilitating expulsion. One cesarean section with extracti on of a live infant was indicated at 38 weeks. One patient was lost to follow-up at 7 months and was seen again only after delivery at home, i.e. without supervision but equally without complications. The 3 new born infants had an Apgar of 10/10 and a birth weight of 3.2-3.5 kilos . There were no spontaneous abortions and no premature deliveries. All 3 patients had a successful pregnancy and delivery without surgical r epair of the coarctation. They were rehospitalised for preoperative an giography and surgical treatment of their coarctation on average 6 mon ths after delivery. The usual technique was Crafford's operation. The postoperative course was good (mean follow-up: 10 years).