Arterial Dissection
Arterial dissections refer to the tearing of the inner wall of an artery. Pregnancy creates stress on the body’s blood vessels and in rare cases dissections can occur.
The condition occurs in .005% of all mothers.
A recent study tried to uncover the prevalence of this condition. Researchers evaluated 27 states included in the Nationwide Readmissions Database.
Taking it Seriously
Just because a rare disease is rare doesn’t mean it should be dismissed as a possibility. This is especially true when the condition is as severe as an arterial dissection is.
The chance of arterial dissection is very low when looking at the population. However, ignoring its possibility can be life-threatening. For this reason, symptoms need to be taken seriously.
If a woman experiences a sudden onset of pain during the first six weeks of postpartum, they should not be dismissed. Clinicians must be aware that the condition exists and understand its symptoms and risk factors. With an understanding of the risk factors, they can recognize the symptoms as soon as they occur.
Not Always Postpartum
Researchers examined a total of 18 million patients who were hospitalized for a pregnancy-related condition from the years of 2010 to 2015. Of all of the patients examined, just 993 had an arterial dissection. That is 5.5 out of every 100,000.
Risk factors include-
- Age
- Multiple pregnancies
- Gestational diabetes
- Gestational hypertension
- A genetic risk for connective tissue disorders like –
Other independent predictors found in the multivariable analysis were-
- Chronic hypertension
- Tobacco use
- Alcohol use
- Heart failure
Surprisingly, obesity was found to be linked with lower risk.
The majority of arterial dissections occurred in postpartum (61.5%). However, they also occurred before or during delivery. The majority of the dissections were coronary, followed closely by vertebral, aortic, and carotid. For those whose dissection occurred before or during birth, the most common were aortic. For those in postpartum, the most frequent were coronary.
Marfan syndrome
The link between arterial dissections and connective tissue disorders was found to be particularly noteworthy for researchers.
One of the takeaways from this research is that women who experience an arterial dissection during labor, delivery, or postpartum should have genetic screening. Spontaneous coronary artery dissection was found to be the most common during postpartum and researchers estimate that 5% of all those with this type of dissection have an underlying genetic condition.
In addition to this genetic screening, it is helpful for patients to know their own medical history and that of their family, and communicate this history to their doctors. This is especially true for women who have a history of diabetes, chronic hypertension, or connective tissue disorders.
A task force focused on cardio-obstetrics is currently being formed within the American College of Cardiology. More research is underway. In the meantime, it is important for patients and physicians to be aware of the condition despite its rarity and to advocate for further testing if anything concerning arises.
You can read more about this condition here.
