Severe Dural Ectasia in a Pregnant Patient With Marfan Syndrome

( Can J Anesth. 2024;71(4):548–549. doi:10.1007/s12630-024-02691-8) Vargas Zúñiga and George publish a case report on a woman with known Marfan syndrome who gave birth through cesarean delivery (CD). The patient was 36 years old and was known to have Marfan syndrome. This was her first pregnancy, which was full term (37+4 wk) at the time of presentation. To understand what limitations they needed to consider for the CD, magnetic resonance imaging (MRI) and transthoracic echocardiography was performed which resulted in finding aortopathy of the ascending aorta, with measurements of 40 and 38 mm, respectively. The patient was also identified to have mild mitral regurgitation, mild scoliosis, and pelvis excavatum. Earlier in the pregnancy, a pelvis and abdominal MRI revealed pronounced dural ectasia in the lumbar and sacral regions of the spine. An MR image of the patient with increased anteroposterior diameter in lumbar and sacral regions was published alongside a view of the normal lumbar spine, for comparison and reference purposes.