A 25-year-old woman with Marfan syndrome attends preconception counselling. Echocardiography shows an aortic root diameter of 4.3 cm. Which statement correctly guides her management?
- A Pregnancy is contraindicated regardless of aortic dimensions
- B Beta blockers are avoided in pregnancy because of fetal growth restriction
- C An aortic root above 4.0 cm confers high risk of dissection and warrants beta blocker therapy with serial echocardiography ✓
- D Elective caesarean section eliminates dissection risk during labour
Correct answer: C. An aortic root above 4.0 cm confers high risk of dissection and warrants beta blocker therapy with serial echocardiography
Explanation
In Marfan syndrome, an aortic root diameter exceeding 4.0 cm marks a high-risk pregnancy with significant risk of aortic dissection; such patients need beta blockade, serial echocardiographic surveillance each 4 to 8 weeks, and consideration of elective surgical repair before conception if the root exceeds about 4.5 cm. Pregnancy is not absolutely contraindicated, beta blockers are routinely used, and mode of delivery does not remove the underlying wall stress risk.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.