Cardiovascular outcomes and aortic growth in pregnant women with Turner syndrome: data from the European Society of Cardiology EURObservational Research Programme Registry of Pregnancy and Cardiac Disease (ROPAC) III - Summary - MDSpire

Cardiovascular outcomes and aortic growth in pregnant women with Turner syndrome: data from the European Society of Cardiology EURObservational Research Programme Registry of Pregnancy and Cardiac Disease (ROPAC) III

  • By

  • Johanna A van der Zande

  • Jasmin Grewal

  • Arie Franx

  • Joanna Hlebowicz

  • Laurent Demulier

  • Thelma C Konings

  • Abdulhalim J Kinsara

  • Julius C Mwita

  • Laurence Bal-Theoleyre

  • Wael Al Mahmeed

  • Lidija McGrath

  • Roger Hall

  • Mark R Johnson

  • Jolien W Roos-Hesselink

  • ROPAC investigators

  • R Ferrari

  • A Alonso

  • J Bax

  • C Blomström-Lundqvist

  • S Gielen

  • P Lancellotti

  • A P Maggioni

  • N Maniadakis

  • F Pinto

  • F Ruschitzka

  • L Tavazzi

  • P Vardas

  • F Weidinger

  • U Zeymer

  • A Vahanian

  • A Budaj

  • N Dagres

  • N Danchin

  • V Delgado

  • J Emberson

  • O Friberg

  • C P Gale

  • G Heyndrickx

  • B Iung

  • S James

  • A P Kappetein

  • A P Maggioni

  • N Maniadakis

  • K V Nagy

  • G Parati

  • A-S Petronio

  • M Pietila

  • E Prescott

  • F Ruschitzka

  • F Van de Werf

  • F Weidinger

  • U Zeymer

  • C P Gale

  • B Beleslin

  • A Budaj

  • O Chioncel

  • N Dagres

  • N Danchin

  • J Emberson

  • D Erlinge

  • M Glikson

  • A Gray

  • M Kayikcioglu

  • A P Maggioni

  • K V Nagy

  • A Nedoshivin

  • A-P Petronio

  • J W Roos-Hesselink

  • L Wallentin

  • U Zeymer

  • B A Popescu

  • D Adlam

  • A L P Caforio

  • D Capodanno

  • M Dweck

  • D Erlinge

  • M Glikson

  • J Hausleiter

  • B Iung

  • M Kayikcioglu

  • P Ludman

  • L Lund

  • A P Maggioni

  • S Matskeplishvili

  • B Meder

  • K V Nagy

  • A Nedoshivin

  • D Neglia

  • A A Pasquet

  • J W Roos-Hesselink

  • F J Rossello

  • S M Shaheen

  • A Torbica

  • Jolien Roos-Hesselink

  • Roger Hall

  • William Parsonage

  • Werner Budts

  • Julie De Backer

  • Jasmin Grewal

  • Ariane Marelli

  • Guillaume Jondeau

  • Mark Johnson

  • Catherine Otto

  • Karen Sliwa

  • Aldo Maggioni

  • K Vardanyan

  • A Melkonyan

  • H Lachikyan

  • K Hakobyan

  • M Mazmanian

  • H Hayrapetyan

  • A Tavaracyan

  • H Poghosyan

  • R Hovhannisyan

  • S Sahakyan

  • S Martirosyan

  • J Harris

  • A Pasquet

  • M Morissens

  • T Besse-Hammer

  • B Dumoulin

  • J De Backer

  • L Campens

  • L Demulier

  • M De Hosson

  • W Budts

  • A Van de Bruaene

  • A Rampelberg

  • E Troost

  • L Roggen

  • P De Meester

  • J C Mwita

  • E Tefera

  • L Kontle

  • A Marelli

  • I Malhamé

  • J Grewal

  • M Janzen

  • P A Román Rubio

  • R Vasallo Peraza

  • G Vázquez Hernández

  • J E Pérez Torga

  • Y Gil Jiménez

  • M Meluzá Martín

  • R Almaleh

  • G Youssef

  • K Sorour

  • S Abebe

  • D Mekonnen

  • C Fekadu

  • D Yadeta

  • S Dupuis-Girod

  • L Delagrange

  • M Richardson

  • L Ghesquiere

  • O Domanski

  • M Gonzalez Estevez

  • Y Ould Hamoud

  • S Gautier

  • L Marsili

  • L Bal-Theoleyre

  • S Palazzolo

  • M Ladouceur

  • G Jondeau

  • A Bourgeois Moine

  • L Eliaou

  • O Milleron

  • M Tchitchinadze

  • Y Dulac

  • C Karsenty

  • N Souletie

  • F Bajanca

  • C Rickers

  • S Blankenberg

  • C Sinning

  • C Magnussen

  • E Zengin

  • G Mueller

  • R Schnabel

  • Y Von Kodolitsch

  • R Kozlik-Feldmann

  • H Baumgartner

  • R Schmidt

  • A Hellige

  • A Rietkötter

  • M Spartalis

  • A A Frogoudaki

  • A Arvanitaki

  • A Baroutidou

  • G Giannakoulas

  • C Karvounis

  • J P Gnanaraj

  • A P Steaphen

  • T Ethirajan

  • K Kannan

  • V Subramanian

  • A Surendran

  • J Gnanasekaran

  • V Natarajalingam

  • S Balasubramani

  • H Ali Farhan

  • I F Yaseen

  • E Mariucci

  • C Ciuca

  • F Marchi

  • G Benedetti

  • M Baroni

  • P Festa

  • A Parlanti

  • G Scognamiglio

  • F Fusco

  • B Sarubbi

  • M Merlo

  • B D'Agata Mottolese

  • C Carriere

  • G Sinagra

  • M Bobbo

  • F Ramani

  • F M Comoglio

  • R Bordese

  • A Pagano

  • N Montali

  • V Donvito

  • C A Remolif

  • F Petey

  • B Bouma

  • S Chamuleau

  • D Robbers-Visser

  • T Konings

  • H Dronkert

  • D Segers

  • R Van Kimmenade

  • H Van Der Zwaan

  • G Tjalling Sieswerda

  • A Evers

  • T Schaap

  • K Bano

  • H Yasmeen

  • K Amir

  • N Patel

  • P Akhter

  • R Khan

  • A Shakeel

  • S Mahar

  • S Habib

  • M Lelonek

  • P Hoffman

  • M Lipczynska

  • L De Sousa

  • V Ferreira

  • T Mano

  • M Selas

  • R Cruz Ferreira

  • E Shlyakhto

  • O Irtyuga

  • G Sefieva

  • K Malikov

  • T Pervunina

  • U Shadrina

  • A Kinsara

  • D Galzerano

  • H Al Sergani

  • W Kurdi

  • N Kholaif

  • O Vriz

  • A Alhamshari

  • A Alsaigh

  • O Ahmad

  • S Alzaher

  • B Alamro

  • K Sliwa

  • F Jakoet-Bassier

  • L Galian-Gay

  • A Pijuan-Domenech

  • B Miranda-Barrio

  • B Gordon

  • E Furenäs

  • J Hlebowicz

  • F Wedlund

  • E Nagy

  • E Mattsson

  • M Majczuk Sennstrom

  • P Sörensson

  • C Christersson

  • A Lutvica

  • B Jönelid

  • T Achter

  • K Junus

  • H Gärdesten Wall

  • M Andreasson

  • D Tobler

  • J Bouchardy

  • F Brand

  • C Blanche

  • J Bouchardy

  • T Rutz

  • F Brand

  • U Canpolat

  • Y Z Sener

  • N Ozer

  • E Ayduk Gövdeli

  • Z Bugra

  • B Umman

  • P Karaca Özer

  • D Baykiz

  • D Mutlu

  • H Yalman

  • B Kilickiran Avci

  • S Catirli Enar

  • O Batukan Esen

  • D Oksen

  • V Lazoryshynets

  • S Siromakha

  • Y Davydova

  • A Limanska

  • I Zinovchyk

  • V Kravchenko

  • B Kravchuk

  • O Kravets

  • N Volkova

  • O Mazur

  • O Beregovyi

  • B T Salih

  • W A R Al Mahmeed

  • S Wani

  • F S Mohamed Farook

  • G Al Mansoori

  • S Prakash

  • R Afifi

  • D Milewicz

  • A Cecchi

  • G Wells

  • D Sparks

  • W Wagner

  • C Bigelow

  • L Colicchia

  • T Jentink

  • M Loichinger

  • R Saxena

  • W Wunderlich

  • C Longtin

  • P Klopper

  • R Gobar

  • J Chou

  • K Campbell

  • R Elder

  • D Halpern

  • A Hausvater

  • H Reynolds

  • N Bhalla

  • A Small

  • J Feinberg

  • P Panday

  • J Awerbach

  • J Porche

  • S Stack

  • L McGrath

  • A Khan

  • E Pare

  • P Woods

  • C Broberg

  • K Gibbins

  • K Brookfield

  • M Al-Sadawi

  • A Cove

  • N Mann

  • September 8, 2025

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Objective:

To examine cardiovascular and pregnancy outcomes in women with Turner syndrome and analyze aortic growth throughout pregnancy, specifically focusing on the implications of these findings.

Key Findings:
  • 47 pregnancies included, with 49% classified as moderate-to-high risk.
  • 60% of pregnancies occurred after ART.
  • No maternal mortality or aortic dissection during or after pregnancy.
  • Hypertensive disorders occurred in 26% of cases, indicating a significant concern.
  • Women who conceived via ART had higher rates of Caesarean delivery (65% vs. 42%) and earlier deliveries (38 vs. 39 weeks).
  • Significant aortic growth observed at the sinus of Valsalva during pregnancy, but diameters were not different from pre-pregnancy after a median follow-up of 7 months.
Interpretation:

Pregnancy outcomes in women with Turner syndrome are better than previously reported, although hypertensive disorders are common and warrant attention. Aortic dilatation may occur during pregnancy but appears reversible postpartum.

Limitations:
  • Small sample size of 47 pregnancies.
  • Observational nature limits causal inferences and may introduce biases.
Conclusion:

Pregnancy in women with Turner syndrome can be managed safely with careful monitoring, and while aortic growth may occur, it is generally reversible postpartum.

Original Source(s)

Cardiovascular outcomes and aortic growth in pregnant women with Turner syndrome: data from the European Society of Cardiology EURObservational Research Programme Registry of Pregnancy and Cardiac Disease (ROPAC) III

  • by Johanna A van der Zande, Jasmin Grewal, Arie Franx, Joanna Hlebowicz, Laurent Demulier, Thelma C Konings, Abdulhalim J Kinsara, Julius C Mwita, Laurence Bal-Theoleyre, Wael Al Mahmeed, Lidija McGrath, Roger Hall, Mark R Johnson, Jolien W Roos-Hesselink, ROPAC investigators, R Ferrari, A Alonso, J Bax, C Blomström-Lundqvist, S Gielen, P Lancellotti, A P Maggioni, N Maniadakis, F Pinto, F Ruschitzka, L Tavazzi, P Vardas, F Weidinger, U Zeymer, A Vahanian, A Budaj, N Dagres, N Danchin, V Delgado, J Emberson, O Friberg, C P Gale, G Heyndrickx, B Iung, S James, A P Kappetein, A P Maggioni, N Maniadakis, K V Nagy, G Parati, A-S Petronio, M Pietila, E Prescott, F Ruschitzka, F Van de Werf, F Weidinger, U Zeymer, C P Gale, B Beleslin, A Budaj, O Chioncel, N Dagres, N Danchin, J Emberson, D Erlinge, M Glikson, A Gray, M Kayikcioglu, A P Maggioni, K V Nagy, A Nedoshivin, A-P Petronio, J W Roos-Hesselink, L Wallentin, U Zeymer, B A Popescu, D Adlam, A L P Caforio, D Capodanno, M Dweck, D Erlinge, M Glikson, J Hausleiter, B Iung, M Kayikcioglu, P Ludman, L Lund, A P Maggioni, S Matskeplishvili, B Meder, K V Nagy, A Nedoshivin, D Neglia, A A Pasquet, J W Roos-Hesselink, F J Rossello, S M Shaheen, A Torbica, Jolien Roos-Hesselink, Roger Hall, William Parsonage, Werner Budts, Julie De Backer, Jasmin Grewal, Ariane Marelli, Guillaume Jondeau, Mark Johnson, Catherine Otto, Karen Sliwa, Aldo Maggioni, K Vardanyan, A Melkonyan, H Lachikyan, K Hakobyan, M Mazmanian, H Hayrapetyan, A Tavaracyan, H Poghosyan, R Hovhannisyan, S Sahakyan, S Martirosyan, J Harris, A Pasquet, M Morissens, T Besse-Hammer, B Dumoulin, J De Backer, L Campens, L Demulier, M De Hosson, W Budts, A Van de Bruaene, A Rampelberg, E Troost, L Roggen, P De Meester, J C Mwita, E Tefera, L Kontle, A Marelli, I Malhamé, J Grewal, M Janzen, P A Román Rubio, R Vasallo Peraza, G Vázquez Hernández, J E Pérez Torga, Y Gil Jiménez, M Meluzá Martín, R Almaleh, G Youssef, K Sorour, S Abebe, D Mekonnen, C Fekadu, D Yadeta, S Dupuis-Girod, L Delagrange, M Richardson, L Ghesquiere, O Domanski, M Gonzalez Estevez, Y Ould Hamoud, S Gautier, L Marsili, L Bal-Theoleyre, S Palazzolo, M Ladouceur, G Jondeau, A Bourgeois Moine, L Eliaou, O Milleron, M Tchitchinadze, Y Dulac, C Karsenty, N Souletie, F Bajanca, C Rickers, S Blankenberg, C Sinning, C Magnussen, E Zengin, G Mueller, R Schnabel, Y Von Kodolitsch, R Kozlik-Feldmann, H Baumgartner, R Schmidt, A Hellige, A Rietkötter, M Spartalis, A A Frogoudaki, A Arvanitaki, A Baroutidou, G Giannakoulas, C Karvounis, J P Gnanaraj, A P Steaphen, T Ethirajan, K Kannan, V Subramanian, A Surendran, J Gnanasekaran, V Natarajalingam, S Balasubramani, H Ali Farhan, I F Yaseen, E Mariucci, C Ciuca, F Marchi, G Benedetti, M Baroni, P Festa, A Parlanti, G Scognamiglio, F Fusco, B Sarubbi, M Merlo, B D'Agata Mottolese, C Carriere, G Sinagra, M Bobbo, F Ramani, F M Comoglio, R Bordese, A Pagano, N Montali, V Donvito, C A Remolif, F Petey, B Bouma, S Chamuleau, D Robbers-Visser, T Konings, H Dronkert, D Segers, R Van Kimmenade, H Van Der Zwaan, G Tjalling Sieswerda, A Evers, T Schaap, K Bano, H Yasmeen, K Amir, N Patel, P Akhter, R Khan, A Shakeel, S Mahar, S Habib, M Lelonek, P Hoffman, M Lipczynska, L De Sousa, V Ferreira, T Mano, M Selas, R Cruz Ferreira, E Shlyakhto, O Irtyuga, G Sefieva, K Malikov, T Pervunina, U Shadrina, A Kinsara, D Galzerano, H Al Sergani, W Kurdi, N Kholaif, O Vriz, A Alhamshari, A Alsaigh, O Ahmad, S Alzaher, B Alamro, K Sliwa, F Jakoet-Bassier, L Galian-Gay, A Pijuan-Domenech, B Miranda-Barrio, B Gordon, E Furenäs, J Hlebowicz, F Wedlund, E Nagy, E Mattsson, M Majczuk Sennstrom, P Sörensson, C Christersson, A Lutvica, B Jönelid, T Achter, K Junus, H Gärdesten Wall, M Andreasson, D Tobler, J Bouchardy, F Brand, C Blanche, J Bouchardy, T Rutz, F Brand, U Canpolat, Y Z Sener, N Ozer, E Ayduk Gövdeli, Z Bugra, B Umman, P Karaca Özer, D Baykiz, D Mutlu, H Yalman, B Kilickiran Avci, S Catirli Enar, O Batukan Esen, D Oksen, V Lazoryshynets, S Siromakha, Y Davydova, A Limanska, I Zinovchyk, V Kravchenko, B Kravchuk, O Kravets, N Volkova, O Mazur, O Beregovyi, B T Salih, W A R Al Mahmeed, S Wani, F S Mohamed Farook, G Al Mansoori, S Prakash, R Afifi, D Milewicz, A Cecchi, G Wells, D Sparks, W Wagner, C Bigelow, L Colicchia, T Jentink, M Loichinger, R Saxena, W Wunderlich, C Longtin, P Klopper, R Gobar, J Chou, K Campbell, R Elder, D Halpern, A Hausvater, H Reynolds, N Bhalla, A Small, J Feinberg, P Panday, J Awerbach, J Porche, S Stack, L McGrath, A Khan, E Pare, P Woods, C Broberg, K Gibbins, K Brookfield, M Al-Sadawi, A Cove, N Mann

  • September 8, 2025

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