Melissa Russo, MD, a maternal-fetal medicine and clinical genetics specialist in the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island, a Care New England hospital, has recently received a $100,000, two-year grant through The Marfan Foundation Grant Program to study the risk factors associated with cardiovascular and obstetric complications in pregnancy among women with a genetic predisposition to aortic dissection. Dr. Russo is the director of Prenatal Genetics at Women & Infants’ Prenatal Diagnosis Center.
Aortic dissection is a life-threatening event in which a tear develops in the inner layers of the aorta, allowing blood to flow through, separating (or dissecting) the inner and middle layers of the aorta. With a dissection in the wall, the blood vessel is weakened and there is a risk for aortic rupture, which can be deadly. The aorta is the main blood vessel from the heart that supplies blood to the entire body. Individuals with genetic conditions such as Marfan syndrome and Loeys-Dietz syndrome are at higher risk than the general population to develop an aortic aneurysm, enlargement of the vessel, and aortic dissection.
“Marfan syndrome is a genetic condition that affects the blood vessels, skeleton, and connective tissues, and these individuals are at risk for aortic dissection. We know that pregnancy in women with Marfan syndrome and related conditions is a high-risk time for aortic dissection, but many of these women, with a prenatal multi-disciplinary care team, can have a successful pregnancy,” said Dr. Russo. “Currently, we cannot predict who will have a successful pregnancy versus a catastrophic event during pregnancy because the risk factors for aortic dissection during pregnancy are not well understood. We are seeking to address this knowledge gap by building a multi-center database for reproductive and pregnancy outcomes in women with a genetic predisposition for aortic dissection. Our long-term goal is to continue this work and build a nationwide database.”
In pregnancy, there is twice as much blood pumping and the heart is working harder to pump the blood around the body. These physiological changes in pregnancy put women with genetic predisposition for aortic aneurysm and dissection at risk for development of these problems during pregnancy. There is currently limited information to predict which of these women will have healthy successful pregnancies and which will have complications in pregnancy. Dr. Russo’s research aims to identify risk factors for poor outcomes in pregnancy and improve the ability to predict a woman’s outcome in a future pregnancy based on these risk factors.
Dr. Russo is also an assistant professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University and a member of Care New England Medical Group. She was recently added as a member of the GenTAC Alliance, a community of stakeholders committed to advancing understanding of genetic thoracic aortic diseases and their treatment. The Alliance builds upon the successes of the GenTAC Registry, which enrolled and followed participants from 2006 to 2016 and seeks to involve a much wider group of stakeholders and be more expansive in scope.
Dr. Russo is available to see men, women, or children with a suspected or known connective tissue disorder. She also performs pre-conception and pregnancy genetic consultations at Women & Infants’ Prenatal Diagnosis Center. Appointments may be made at (401) 274-1122, ext. 47096.
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