Type A acute aortic dissection (TAAD) during pregnancy is a
life-threatening event for both the mother and unborn baby. Pregnancy
has been recognised as an independent risk factor for TAAD, postulated
to be due to physiological changes that cause hyperdynamic circulation.
Presentation can be atypical in many cases and further concern from
clinicians of fetal radiation exposure can result in missed or delayed
diagnoses. Investigation via quickest form of imaging, whether CT, MRI
or transoesophageal echocardiography, should be carried out promptly due
to the high risk of mortality. Surgical management of TAAD in pregnancy
revolves primarily around the decision to deliver the foetus
concomitantly or to perform aortic repair with the foetus in utero. This
review will summarise the difficulties faced when managing TAAD in
pregnancy, and important questions for future research.