Professor Richard Gibbs
Imperial College NHS Trust
Cleveland Clinic London
Cardiovascular diseases complicate 1-4% of pregnancies with a higher prevalence when hypertensive disorders are included, and are the leading cause of death in pregnant women in developed countries, accounting for up to 16% of maternal mortality. Vascular catastrophes in pregnancy are rare but are associated with significantly worse outcomes than the same acute disease processes in the non-pregnant population. Ruptured splenic artery aneurysms carry a mortality of 25% that rises disproportionately to 75% in pregnant women with a fetal mortality of up to 95%. The risk of aortic dissection increases 25X in pregnancy and is associated with a pre-hospital mortality of 53%, and an individual case fatality rate of 60%. There is significant scope to improve outcomes in acute vascular diseases complicating pregnancy predicated on both faster recognition of the conditions and the improvements in both medical and surgical interventions.