Pregnant Woman at 22 Weeks Undergoes Rare Aortic Dissection Surgery with Fetus In Utero

In a remarkable feat of medical collaboration, doctors at Milan's Niguarda Hospital have successfully performed a life-saving surgery on a pregnant woman suffering from an aortic dissection, managing to preserve the fetus within her womb. The patient, identified as Matilde, was 22 weeks pregnant when she experienced a tear in her aorta, the body's main artery, a condition that poses an immediate threat to both mother and child.

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Mom and baby are doing well and are a testament to an intervention that has very few similar examples in international scientific literature.

The multidisciplinary team, comprising gynecologists, cardiac surgeons, and neonatologists, faced a critical decision: immediate surgery was necessary for the mother's survival, but the fetus was too premature for delivery. They opted for a groundbreaking approach, performing a seven-hour surgery to repair the aorta while ensuring the pregnancy could continue as long as possible.

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A very serious cardiac condition with immediate risk to the mother's life and therefore also the fetus occurred, a condition that required the immediate execution of a complex cardiac surgical intervention.

"A very serious cardiac condition with immediate risk to the mother's life and therefore also the fetus occurred," explained Claudio Russo, director of Cardiac Surgery at Niguarda. "A condition that required the immediate execution of a complex cardiac surgical intervention." Neonatologists determined that an earlier birth would be too risky, leading to the decision to proceed with the aortic repair while maintaining the pregnancy.

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We had to intervene on the aorta, doing everything possible to allow the pregnancy to continue.

Following the surgery and a brief stay in intensive care, Matilde was closely monitored by cardiology and gynecology specialists. The pregnancy progressed to 34 weeks, at which point a cesarean section was performed. Months later, both mother and child are reported to be in good health, a testament to the exceptional teamwork and innovative medical care provided. Hospital officials noted that another similar case recently occurred, further highlighting the success of their collaborative approach in managing such rare and high-risk pregnancies.

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Recently, another patient with acute aortic dissection during advanced pregnancy was operated on here, in which an emergency cesarean section preceded the cardiac surgery. The two cases represent a clinical success, but also an example of the value of public healthcare and collaboration among professionals.