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CME Credit Offered
CME Credit Offered
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Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
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AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Medical/Surgical/Diseases/Complications

Poster Session 2

(574) Aortopathies and Hypertrophic Cardiomyopathy in Pregnancy

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Madeline P. McKenna, MD (she/her/hers)

    OBGYN Resident
    Cleveland Clinic Akron General
    Akron, Ohio, United States

    • Coauthor(s)

  • MI

    Marisa R. Imbroane, BSc

    Medical Student
    Case Western Reserve University School of Medicine
    Case Western Reserve University School of Medicine/Cleveland, Ohio, United States

  • Dana Baraki, MD

    Resident Physician
    Cleveland Clinic
    Cleveland Clinic/Cleveland, Ohio, United States

  • AA

    Ahmed Ahmed, MD, MSc, RDMS

    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Ohio, United States

  • AM

    Amol Malshe, MD

    MFM
    Cleveland Clinic Foundation
    Cleveland Clinic Foundation, Ohio, United States

Objective:
To assess obstetric risks in patients with aortic dissection, thoracic/abdominal aneurysms, and hypertrophic obstructive cardiomyopathy (HOCM), compared to matched controls.

Study Design:
We conducted a retrospective cohort study using the US collaborative network on the TriNetX database, including patients with outcomes of interest from the last 20 years. ICD-10 codes were used to identify and evaluate pregnancy outcomes in patients with aortopathies (dissection, thoracic, and abdominal aneurysms) and HOCM. Relative risk (RR) and 95% confidence intervals (CI) were calculated to assess the key outcomes of hypertensive disorders, fetal growth restriction (FGR), intrauterine fetal demise (IUFD), and preterm birth.

Results:
Aortic dissection was associated with a more than twofold increased risk of both preeclampsia (11.9% vs 4.9%) and preterm birth (4.9% vs 2.2%). Thoracic aneurysms significantly increased the risk of gestational hypertension (gHTN) (7.0%) and preterm delivery (3.6%) compared to controls. Abdominal aneurysms presented a striking 2.38-fold elevated risk of FGR (5.9% vs 2.5%). When combined, thoracic and abdominal aneurysms were associated with increased rates of preeclampsia (6.2%), gHTN (6.6%), FGR (5.2%), placental abruption (1.0%), and preterm birth (3.4%). HOCM was also high risk, associated with over twofold increases in both FGR and preterm delivery compared to controls. All noted findings were statistically significant with p < 0.0001.

Conclusion:
Aortopathies and HOCM confer significant obstetric risk, particularly for hypertensive disease, FGR, and preterm birth. These outcomes likely reflect disrupted maternal cardiovascular adaptation and altered perfusion, implicating hemodynamic compromise as a contributing factor to poor placental function and fetal growth. These findings underscore the importance of tailored multidisciplinary care and close antenatal surveillance for pregnant patients with aortopathies and HOCM to mitigate maternal and fetal risks.