Neonatal morbidity appears slightly increased among women with a TOLAC. However, morbidity and mortality are considerably increased in cases of uterine rupture. Appropriate selection and counseling of women for TOLAC should be undertaken as to minimize uterine rupture risk.
authors contributed equally.
Funding InformationShandong Province Science and Technology Development Plan K E Y W O R D S : Aortic dissection; Pregnancy; Triple-branched stent graft A woman aged 36 years at 36 weeks of pregnancy sought medical attention at the Shandong Provincial Hospital affiliated to Shandong University, Shandong, China, after experiencing acute chest pain. The patient was diagnosed with chronic hypertension, severe preeclampsia, acute aortic dissection, aortic regurgitation, and heart failure. Computed tomography examination demonstrated a DeBakey type I aortic dissection that involved the origin of the innominate artery, the left common carotid artery, and the left subclavian artery. Cardiotocography monitoring revealed no obvious fetal anomalies; this was thought to result from the relatively normal uterine-placental arterial supply that was unaffected by aortic dissection. The patient underwent cesarean delivery with hysterectomy and relevant cardiovascular treatment 3 days after admission. A median sternotomy was performed under general anesthesia and total cardiopulmonary bypass was established. Subsequently, the attending obstetrician performed the cesarean delivery and hysterectomy.
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