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Paediatrics — UKMLA MCQ

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HardPaediatricsUKMLAMRCP Part 1

A woman with Turner syndrome seeks donor-oocyte pregnancy. Cardiac MRI shows an ascending aortic size index of 2.7 cm/m2. What is the most appropriate advice?

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Correct answer: C — Advise against pregnancy at this aortic dimension

The best answer is “Advise against pregnancy at this aortic dimension”. Turner syndrome carries a disproportionate risk of aortic dissection during pregnancy. Severe indexed aortic dilatation, particularly at or above 2.5 cm/m2, is considered prohibitive; assisted conception does not remove that haemodynamic risk. Surveillance and blood-pressure control are essential for lower-risk women but cannot make this degree of dilatation safe. Planned caesarean delivery also does not eliminate antepartum or postpartum dissection risk.

Reference: Turner syndrome 2023 international guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11759048/