Marfan syndrome affects the connective tissue. It can cause problems in many parts of your body, including your joints, bones, eyes, heart and blood vessels. If you have Marfan syndrome and are considering pregnancy, it is very important to talk to your healthcare provider. The condition and treatments increase the chance of problems for both you and the fetus.
Pregnancy creates extra stress on the heart and blood vessels. The biggest concern for patients with Marfan syndrome is serious complications of the aorta, such as a tear or rupture that can cause death or serious injury to both you and the fetus. The risk is greatest if your aorta is dilated more than 4 cm. If this is the case, you should wait to become pregnant until after you have surgery to repair your aorta.
Your doctor will talk to you about the best options for delivery. If you have a dilated aorta, you will likely have a cesarean section. Otherwise, you can probably deliver vaginally. An epidural can help keep your blood pressure stable and reduce the strain on your heart and blood vessels during labor.
Because Marfan syndrome is a genetic disorder, your children have 50% chance of having the disease. If the genetic cause of your Marfan syndrome is known, your children can be tested for the condition during pregnancy (using amniocentesis) or after birth (with a blood test). If the exact cause is not known, your children should have close medical follow-up during their lives to check for signs of the disease.
Management and Treatment
Medications used to treat patients with Marfan syndrome, such as angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can cause serious birth defects. You will need to stop these medications and switch to safer choices during your pregnancy.
While you are pregnant, you will need to see your doctor regularly and have your aorta and possibly your heart valves checked at least once each trimester. It is also important to keep your blood pressure under control.
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