作者报导一妊娠37周19岁妇女发生夹层动脉瘤,即予剖腹产娩出一正常婴儿,48小时后方行主动脉根部置换术。文中认为: 夹层动脉瘤多由高血压所致。若高血压被控制,不会发生自发性夹层动脉瘤已经证实。其他危险因素,如马凡氐综合征、损伤、双瓣型主动脉瓣和妊娠亦被认识。妊娠期主动脉壁夹层分离少见,且主要见于妊娠9月,此期血容量及心排量最大,但也可见于妊娠全期及分娩后数周,初产妇较易罹受。育龄妇女50%夹层动脉瘤见于妊娠中,而血压升高与多数妊娠,特别是首次妊娠相关,是孕妇发生夹层动脉瘤比同龄非妊娠者高的原因。本病例整个妊娠期血压正常,其发生夹层动脉瘤则与主动脉瓣呈双瓣型相关。尸解发现双瓣型主动脉瓣占夹层动脉瘤10%。 The authors report a 19-year-old woman with a dissection aneurysm at 37 weeks of gestation who gave a normal infant a caesarean section and aortic root replacement 48 hours later. The article believes that: dissection aneurysms caused by high blood pressure. Spontaneous dissection aneurysms have not been confirmed if hypertension is controlled. Other risk factors such as Marfan syndrome, injury, bicuspid aortic valve and pregnancy are also known. Separation of aortic dissection during pregnancy rare, and mainly seen in pregnancy in September, the maximum volume of blood volume and cardiac output, but also in the whole pregnancy and delivery weeks after delivery, primipara easier to suffer. 50% of women of childbearing age dissection aneurysm found in pregnancy, and elevated blood pressure and most of pregnancy, especially the first pregnancy-related, pregnant women with disseminated aneurysm than non-pregnant women of the same age reasons. This case of normal blood pressure during pregnancy, the occurrence of dissection aneurysm with aortic valve was double-lobe-related. Autopsy found that double-lobe aortic valve dissecting aneurysms accounted for 10%.