Acute Aortic Dissection in the Third Trimester of Pregnancy as an Initial Presentation of Marfan Syndrome.

Aortic dissection is rare and more common in men. In women, it is more frequent during pregnancy, especially in the third trimester. We present the case of a 30-year-old pregnant woman diagnosed with type B aortic dissection at 29 weeks of gestation. Following the diagnosis, fetal maturation was initiated, and the patient was transferred to a tertiary care center. Due to uncontrolled hypertension and persistent pain, and after evaluating the maternal and fetal risk-benefit, a cesarean section was performed at 29 weeks and six days. During the postoperative period, a multi-drug regimen was required for blood pressure control, but the patient recovered and was discharged. Genetic testing, prompted by a family history of sudden death (brother) and aortic dissection (father), identified a mutation in the FBN1 gene, confirming Marfan syndrome. This case highlights the importance of comprehensive patient history, the challenges of aortic dissection during pregnancy, and the need for a multidisciplinary approach in these cases.