Pregnancy for a woman with Marfan's syndrome can be hazardous for both her and the fetus, making it a high-risk pregnancy.

Key issues:

(1) genetic and pre-pregnancy counseling

(2) risk of aortic dissection or rupture of aneurysms

(3) complications of antihypertensive medications

(4) complications of substance abuse

(5) complications of pregnancy-related hypertension


Since Marfan syndrome shows autosomal dominant inheritance the fetus will probably be affected.


There is an increased risk for aortic dissection, especially:

(1) if the maximal aortic dimension is > 4.0 cm

(2) during third trimester, delivery and the early post-partum period

Consequently, echocardiography is performed during pregnancy to monitor aortic root size.


ACE inhibitors or ARBs can be teratogenic for the fetus and need to be discontinued. Beta-blockers may be continued.


The risk of aortic dissection may increase with:

(1) substance abuse with cocaine or amphetamines

(2) pre-eclampsia or eclampsia

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