Successful multidisciplinary treatment of cardiac tamponade from type A aortic dissection rupture in a pregnant woman with pre-eclampsia: a case report.

BACKGROUND

Aortic dissection is a rare but potentially fatal condition. In pregnant women, although aortic dissection incidence is low, it presents with sudden onset, rapid progression, frequent diagnostic errors, substantial surgical risks, and high mortality for both mother and fetus. A 38-year-old Chinese woman, gravida 5 para 2, with chronic hypertension and pre-eclampsia, experienced sudden back pain and dyspnea at 37 weeks of gestation. Within 90 min, she was diagnosed with aortic dissection and cardiac tamponade. A multidisciplinary team conducted a cesarean section, ligated the ascending branches of the bilateral uterine arteries, and performed intrauterine balloon tamponade. Concurrently, they executed coronary artery repair, along with the ascending aorta and partial aortic arch replacement. Both maternal and fetal outcomes were favorable, and the patient's fertility was preserved.

CONCLUSION

Type A aortic dissection during pregnancy is a critical condition. Early diagnosis and tailored plans through multidisciplinary cooperation can achieve good maternal and neonatal outcomes. Uterine artery ligation and Bakri balloon compression during cesarean sections effectively preserve fertility.