Coarctation of the Aorta and Pregnancy

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Abstract
THE ALTERED cardiovascular hemodynamics associated with coarctation of the aorta are well understood. The changes in blood-flow pattern in the abdominal aorta and its pelvic branches produced by coarctation have considerable significance to the obstetrician who cares for the woman with coarctation who becomes pregnant. The essential physiologic alterations produced by coarctation (Figure) are as follows: (1) decreased pulse pressure (or "damping") of the pulse contour in the aorta and all arterial branches originating below the coarcted segment in the descending thoracic aorta; (2) increased arterial blood pressure in the aortic arch proximal to the coarctation and in the branches of the aortic arch; (3) increased left ventricular work because of hypertension in the proximal aorta; (4) extensive collateral arterial circulation, carrying blood from the hypertensive branches proximal to the coarctation to the abdominal aorta distally. Usually, these collaterals provide a fairly normal mean arterial pressure and a near normal

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