Materno-fetal cardiovascular complications in Turner syndrome after oocyte donation: insufficient prepregnancy screening and pregnancy follow-up are associated with poor outcome
Abstract
CONTEXT: Recombinant human GH treatment and oocyte donation (OD) have improved the quality of life in women with Turner syndrome (TS). However, life expectancy is reduced, mainly due to cardiovascular complications. Pregnancy may itself increase that risk and be associated with hazardous materno-fetal outcome. OBJECTIVE: The objective of this study was to evaluate the materno-fetal outcome of ongoing pregnancies beyond 20 wk of gestation obtained by OD in TS. DESIGN: This was a multicenter retrospective study including all assisted reproductive technology centers affiliated with the French Study Group for Oocyte Donation. RESULTS: Among 93 patients, only 37.6% were prescreened with echocardiography or thoracic magnetic resonance imaging. Maternal outcome was dominated by 37.8% of pregnancy-associated hypertensive disorders including preeclampsia in 54.8% and severe eclampsia in four patients. Prematurity occurred in 38.3% and was correlated with pregnancy-associated hypertensive disorder (P = 0.01). The frequency of in utero growth retardation was 27.5%. One fetal demise was linked to eclampsia. Two patients died from aortic rupture after cesarean section in a context of aortic root dilatation. Only 40% of pregnancies were associated with an absolutely normal materno-fetal outcome. CONCLUSIONS: OD pregnancies in TS who have not been managed following recent specific recommendations were at high risk for maternal death by aortic dissection and for preeclampsia and its complications (fetal distress and in utero growth retardation). These recommendations include previous echocardiography, thoracic magnetic resonance imaging, and overnight blood pressure monitoring associated with a tight follow-up during pregnancy. Until future assessment of these recent recommendations, pregnancies obtained in TS after OD must be still considered as very high-risk pregnancies.
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Women with TS are at increased risk for hypertensive disorders of pregnancy, including pre-eclampsia.
“Women with TS are at increased risk for hypertensive disorders of pregnancy, including pre-eclampsia.522-524”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [523]
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♂♀Disorders of Sexual Development
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- Authors
- Chevalier, N., Letur, H., Lelannou, D., Ohl, J., Cornet, D., Chalas-Boissonnas, C., Frydman, R., Catteau-Jonard, S., Greck-Chassain, T., Papaxanthos-Roche, A., Dulucq, M.-C., Couet, M.-L., Cédrin-Durnerin, I., Pouly, J.-L., Fénichel, P., & the French Study Group for Oocyte Donation
- Affiliations
- Inserm (FR)
- Institute Mutualiste Montsouris (FR)
- Eurométropole de Strasbourg (FR)
- Hôpital Tenon (FR)
- Hôpital Antoine-Béclère (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Hôpital Arnaud de Villeneuve (FR)
- Hôpital Pellegrin (FR)
- Corresponding author
- Fénichel, Patrick
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-02
- Volume
- 96
- Issue
- 2
- Pages
- E260-E267
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2109605450
- Cited by
- 142
- References
- 57
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 13 · 2023: 9 · 2022: 14 · 2021: 4 · 2020: 15 · 2019: 9 · 2018: 8 · 2017: 6 · 2016: 10 · 2015: 4 · 2014: 13 · 2013: 12 · 2012: 12
- FWCI
- 6.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- Turner syndrome, oocyte donation, pregnancy complications, maternal cardiovascular risk, aortic dissection, aortic root dilatation, preeclampsia, eclampsia, preterm birth, fetal growth restriction, echocardiography, thoracic magnetic resonance imaging, pregnancy follow-up
- MeSH terms
- Adult, Birth Weight, Female, Humans, Infant, Newborn, Infant, Newborn, Diseases, Infant, Small for Gestational Age, Obstetric Labor, Premature, Pregnancy, Pregnancy Complications, Cardiovascular, Pregnancy Outcome, Prenatal Care, Retrospective Studies, Turner Syndrome, Ultrasonography, Treatment Failure, Guidelines as Topic, Pregnancy, High-Risk, Oocyte Donation
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