Successful management of acute type A aortic dissection in the third trimester of pregnancy: A case report

• Published in: Case reports in women's health 2025-03, Vol.45, Article e00678
• Main Authors: Abdul-Hafez, Hamza A., Khadra, Mahmoud N., Hamed, Alaa, Majjad, Ibrahim Ayman, Barakat, Mohammed A., Nazzal, Adham B., Al-Khdour, Issa
• Format: Article
• Language: English
• Subjects: Abdominal pain; Aortic dissection; Bentall procedure; Case report; Pregnancy
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2024.e00678

Acute type A aortic dissection during pregnancy is rare but life-threatening. It requires early multidisciplinary diagnosis and intervention to optimize maternal and fetal outcomes. We report the case of a 35-year-old woman (gravida 7 para 6) at 34 weeks of gestation who presented with epigastric pain, initially suspected to be gastroenteritis. Despite stable initial findings, her condition deteriorated and a CT angiogram confirmed the diagnosis of DeBakey Type I aortic dissection, which extended from the aortic root to the iliac arteries. She underwent an emergency cesarean section followed by a Bentall procedure, a surgical technique first described by Bentall and De Bono in 1968 to manage the aortic valve, root, and ascending aorta abnormalities. Both mother and baby survived, with an uneventful recovery. However, this case highlights the diagnostic challenges of aortic dissection in pregnancy, as non-specific symptoms can mimic benign conditions. Multidisciplinary management and timely surgical intervention are crucial for maternal and fetal survival. •Acute aortic dissection is an emergent event with significant threat to life, especially in pregnancy.•Aortic dissection may present with non-specific, misleading symptoms, particularly during pregnancy.•Timely multidisciplinary management is crucial to optimize the outcome and survival.