Letter to the Editor
Turner syndrome and pregnancy: A multidisciplinary approach
Síndrome de Turner e gravidez: uma abordagem multidisciplinar
Ruth Alvarez, María Luisa Rodríguez, María Martín
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Cardiology Department, Hospital Universitario Central de Asturia, Oviedo, Asturias, Spain
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array:3 [ 0 => array:2 [ "nombre" => "Ruth" "apellidos" => "Alvarez" ] 1 => array:2 [ "nombre" => "María Luisa" "apellidos" => "Rodríguez" ] 2 => array:4 [ "nombre" => "María" "apellidos" => "Martín" "email" => array:1 [ 0 => "mmartinf7@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Cardiology Department, Hospital Universitario Central de Asturia, Oviedo, Asturias, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Síndrome de Turner e gravidez: uma abordagem multidisciplinar" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the review article recently published in your journal by Donato and Ferreira concerning cardiovascular disease and Turner syndrome.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> It is a very welcome article, as Turner syndrome, although an infrequent condition, is important from a cardiological point of view. The work reminds us of the need for cardiological screening in these patients as well as the follow-up that should be performed. On the other hand, pregnancy is now possible thanks to oocyte donation, but this requires pre-pregnancy counseling that must be taken into account. The most recent ESC guidelines (2018) on cardiovascular diseases during pregnancy<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> specifically state that Turner syndrome is a contraindication for pregnancy (modified World Health Organization level IV) with an aortic diameter greater than 25 mm/m<span class="elsevierStyleSup">2</span>. Moreover, the possibility of both type A and type B dissection is present, and therefore careful and periodic aortic assessment should be performed, especially during pregnancy. The guidelines recommend the creation of pregnancy heart teams in order to assess risk prior to and during pregnancy and also to decide the time and mode of delivery. The review by Donato and Ferreira helps increase knowledge and awareness of this condition and compels us to consider the creation of multidisciplinary work teams for both diagnosis and follow-up. We thank the authors.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiovascular risk in Turner syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Donato" 1 => "M.J. Ferreira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2017.08.008" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2018" "volumen" => "37" "paginaInicial" => "607" "paginaFinal" => "621" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29866389" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ESC Scientific Document Group" "etal" => true "autores" => array:3 [ 0 => "V. Regitz-Zagrosek" 1 => "J.W. Roos-Hesselink" 2 => "J. Bauersachs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehy340" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2018" "volumen" => "39" "paginaInicial" => "3165" "paginaFinal" => "3241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30165544" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003700000011/v1_201812150634/S2174204918303957/v1_201812150634/en/main.assets" "Apartado" => array:4 [ "identificador" => "29282" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003700000011/v1_201812150634/S2174204918303957/v1_201812150634/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204918303957?idApp=UINPBA00004E" ]
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