Pregnancy in individuals with Turner syndrome is a high-risk clinical situation. Cardiovascular complications, particularly hypertensive disorders, require active, protocol-driven management throughout the peripartum period.
This protocol is specific to the pregnant individual with Turner syndrome. The combination of Turner syndrome and pregnancy introduces significant cardiovascular risk, making blood pressure management a central priority of care.
Management centres on tight blood pressure control achieved through antihypertensive therapy, combined with a preventive medication strategy started at a defined point in gestation to reduce the risk of hypertensive pregnancy complications. In individuals with certain aortic findings, an additional class of cardiac agent may also be part of the approach. The complete regimen — including sequencing, thresholds, and agent selection — is available in the full protocol.
Target: BP < 130/80 mm HgDOI: 10.1093/ejendo/lvae050
We recommend tight blood pressure control to a target of less than 130/80 mm Hg during the peripartum period. Antihypertensive therapies and low dose aspirin for the prevention of adverse pregnancy outcomes due to preeclampsia and related hypertensive disorders should be administered according to current clinical practice guidelines.
To prevent hypertensive disorders of pregnancy, it is recommended to start 75-81 mg aspirin daily beginning at 12 weeks of gestation until delivery.
Beta-blockers may be considered during pregnancy for women with aortic dilation (extrapolated from data for women with Marfan syndrome) and do not cause fetal abnormalities.
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