Cauldwell M, et al. - In this retrospective cohort study, researchers sought for maternal and perinatal outcomes in pregnancies complicated by Loeys–Dietz syndrome (LDS). As per early reports, these women exhibit high rates of complications during pregnancy and the puerperium, including aortic dissection and uterine rupture. They identified 20 pregnancies in 13 women with LDS. One miscarriage, one termination of pregnancy, and 18 livebirths were identified. This cohort had no aortic dissections during pregnancy or postpartum but commonly displayed obstetric complications, including postpartum haemorrhage (33%) and preterm delivery (50%). In all, elective caesarean section was undertaken in 14/18 (78%) of deliveries at a median gestational age of 37 weeks. Admission to the neonatal unit was required for over half of the infants (56%) following delivery. Findings emphasize undertaking multidisciplinary specialist management in women with LDS throughout pregnancy. Preconception counseling to these women is recommended to make informed decisions around pregnancy risk and outcomes. Balancing early elective preterm delivery needs against a high infant admission rate to the neonatal unit is recommended.