A genetic disorder affecting the tissues connecting all the organs of the body, the Marfan syndrome affects people of all races and ethnic backgrounds. As per the statistical analysis, commonly prevalent in America, this syndrome affects at least 1 out of 5000 people in the country. Due to the abnormal chemical composition of this syndrome the strength of the connective tissue, which connects all the cells tissues and organs in a body, is weakened. The heart, blood vessels, cartilage, lungs, bones, nervous system, tendons, skin, eyes, and other vital organs of the body are adversely affected. Studies have shown that the Marfan syndrome severely damages the aorta by rupturing its inner layer that causes bleeding in the wall of the vessel further affecting the effective supply of blood to the other parts of the body. The other danger of Marfan syndrome is a mitral valve prolapse that causes breathlessness and rapid and irregular heart beat in the patient suffering from this disorder.
Effect of Marfan Syndrome on Pregnancy
Women suffering with Marfan syndrome are in much danger as this disorder enhances pressure on the heart and blood vessels. Though some women suffering with this disorder sail through the entire course of pregnancy but there are several factors associated which may turn hazardous for them including:
- There is always a serious risk of tearing or rupturing of the aorta if the aortic diameter exceeds more than 10 percent from the normal size. But this does not state that when the aortic dimension is less than 4.0 centimeters then the pregnant woman is out of danger. This may become fatal for the mother or the fetus.
- Any pregnant woman suffering from the Marfan syndrome is always on high risk pregnancy and therefore it is recommended that such patients should be examined at least three times a week through echocardiography. This enables the doctors to monitor the risks and give adequate treatment for a sustained pregnancy.
- Drugs like Coumadin, used to cure Marfan syndrome, may adversely harm the pregnant women. Coumadin, a warfarin drug, administered to women who have undergone a composite graft surgery of the arotic root including an artificial blood vessel or aortic valve has harmful effects on the growing fetus. It has a severe risk on pregnant women because there is a prevalent tendency of the other arotic valves to expand and rupture and affects the supply of blood to other organs of the body.
- Treatment of Marfan syndrome during pregnancy is risky for both mother and child. Certain medicines like Enalapril or Captopril, enzyme inhibitors converting angiotensin, and Losartan, the angiotensin receptor blockers, which are used for treating the Marfan syndrome may cause serious birth defects or a fetal loss. Therefore the use of such medicines is prohibited during pregnancy.
- Pregnant women with Marfan syndrome are always on high risk, therefore to ensure safe deliveries it is recommended that stress free delivery methods should be used for such patients. However, a cesarean delivery is not mandatory for any such pregnancy but in case of any risk or much evident problem it is preferred to a normal delivery.
- Due to higher risk possibilities in a later age pregnancy for women with Marfan syndrome, such patients are recommended to plan their pregnancy in an early age.
- Being a genetic disorder there are high chances of this syndrome being transmitted from the mother to the child.
Women with Marfan syndrome require expert prenatal supervision, supervision during pregnancy and even after delivery and postnatal supervision. The patient suffering from this disorder needs at detailed counseling regarding the risk of transmission of the disease, possible alternatives to pregnancy, phenotypic variability, and the convenience of prenatal diagnostic to calculate risk factors.