Baseline and routine serial measurements of the aortic size are useful, with im- aging interval determined by the indexed size and rate of progression. Pregnancy in Turner syndrome, which often requires assisted reproductive technology, is asso- ciated with an increased risk of aortic dissection, espe- cially if there is a preexisting abnormality of the aortic valve or aorta.S4.2.4.1-4 Recommendation-Specific Supportive Text 1. Women with Turner syndrome are at substantial risk of BAV, CoA, and aortic enlargement, which can result in morbidity and mortality if left un- treated. Therefore, evaluation is necessary to help decide what interventions may be necessary and provide accurate risk assessment for exercise, pregnancy, or other considerations that could be influenced by aortic pathology. 2. Because of case series reporting dissection at smaller aortic diameters than in non-Turner aor- topathy, prophylactic surgery is reasonable at lower diameters, particularly if rapid dilation is present. Measurements must take into account the patient's stature either by indexing to body surface area utilizing Turner-specific norma- tive data or by using ratio of aortic area to body Several CHD subtypes and/or repairs are associated with enlargement of the aorta. The management of these varies by condition, as some are perceived to have a stronger association with aortic dissection or rupture than others, although the true natural history of most is unknown. There is wide heterogeneity of timing of surgical referral, which makes interpretation of longitu- dinal studies problematic. 