open access
Vol 88, No 12 (2017)
Research paper
Published online: 2017-12-29
Get Citation
Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis
, ,
open access
Vol 88, No 12 (2017)
ORIGINAL PAPERS Gynecology
Published online: 2017-12-29
Abstract
Objectives: To investigate the clinical features, disposition, and effect of pregnancy complicated with Takayasu arteritis (P-TA) on maternal and fetal outcomes.
Material and methods: The clinical data (diagnosis and treatment, peri-pregnancy monitoring, and pregnancy outcomes) of patients with P-TA treated in our hospital between September 2007 and April 2016 were analyzed retrospectively.
Results: Among the 13 P-TA cases, seven were diagnosed before pregnancy, and six were diagnosed during pregnancy; six cases were diagnosed as the generalized type, and seven cases were diagnosed as the cephalic-brachial type; six cases were in the stable stage, and seven cases were in the active stage. All the cases in the active stage underwent glucocorticoid therapy. Four cases developed complications, including cardiac dysfunction combined with preeclampsia in two cases, preeclampsia in one case, and stroke in one case. Eleven patients successfully delivered (nine cases of full-term delivery and two cases of premature delivery); one patient had late miscarriage; one patient had missed abortion. All the parturients survived and delivered 11 neonates (nine full-term neonates and two premature neonates) and one low-birth-weight neonate; no neonatal asphyxia or death occurred.
Conclusions: Patients with P-TA can have better maternal and child outcomes through timely diagnosis and treatment, dynamic monitoring, or timely pregnancy termination.
Abstract
Objectives: To investigate the clinical features, disposition, and effect of pregnancy complicated with Takayasu arteritis (P-TA) on maternal and fetal outcomes.
Material and methods: The clinical data (diagnosis and treatment, peri-pregnancy monitoring, and pregnancy outcomes) of patients with P-TA treated in our hospital between September 2007 and April 2016 were analyzed retrospectively.
Results: Among the 13 P-TA cases, seven were diagnosed before pregnancy, and six were diagnosed during pregnancy; six cases were diagnosed as the generalized type, and seven cases were diagnosed as the cephalic-brachial type; six cases were in the stable stage, and seven cases were in the active stage. All the cases in the active stage underwent glucocorticoid therapy. Four cases developed complications, including cardiac dysfunction combined with preeclampsia in two cases, preeclampsia in one case, and stroke in one case. Eleven patients successfully delivered (nine cases of full-term delivery and two cases of premature delivery); one patient had late miscarriage; one patient had missed abortion. All the parturients survived and delivered 11 neonates (nine full-term neonates and two premature neonates) and one low-birth-weight neonate; no neonatal asphyxia or death occurred.
Conclusions: Patients with P-TA can have better maternal and child outcomes through timely diagnosis and treatment, dynamic monitoring, or timely pregnancy termination.
Get Citation
Keywords
pregnancy, Takayasu arteritis, treatment, prognosis
About this articleTitle
Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis
Journal
Issue
Article type
Research paper
Pages
654-661
Published online
2017-12-29
Page views
1745
Article views/downloads
1872
DOI
Pubmed
Bibliographic record
Ginekol Pol 2017;88(12):654-661.
Keywords
pregnancy
Takayasu arteritis
treatment
prognosis
Authors
Yingjia Zhang
Yanna Li
Jun Zhang
References (23)- Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum. 1990; 33(8): 1129–1134.
- Gupta S, Chhabra P, Gupta N, et al. Recurrent first-trimester abortion in a young female: Rare presentation of Takayasu arteritis. J Family Med Prim Care. 2016; 5(3): 719–721.
- Mirault T, Messas E. Takayasu arteritis. Rev Med Interne. 2016; 37(4): 223–229.
- Johnston SL, Lock RJ, Gompels MM. Takayasu arteritis: a review. J Clin Pathol. 2002; 55(7): 481–486.
- Nalini S, Santa SA. Takayasu Arteritis with Bilateral Renal Artery Stenosis and Left Subclavian Artery Stenosis in Pregnancy. J Clin Diagn Res. 2015; 9(9): QD07–QD08.
- Machen L, Clowse MEB. Vasculitis and Pregnancy. Rheum Dis Clin North Am. 2017; 43(2): 239–247.
- Gudbrandsson B, Wallenius M, Garen T, et al. Takayasu Arteritis and Pregnancy: A Population-Based Study on Outcomes and Mother/Child-Related Concerns. Arthritis Care Res (Hoboken). 2017; 69(9): 1384–1390.
- Pagnoux C, Mahendira D, Laskin CA. Fertility and pregnancy in vasculitis. Best Pract Res Clin Rheumatol. 2013; 27(1): 79–94.
- Tanaka H, Tanaka K, Kamiya C, et al. Analysis of pregnancies in women with Takayasu arteritis: Complication of Takayasu arteritis involving obstetric or cardiovascular events. Journal of Obstetrics and Gynaecology Research. 2014; 40(9): 2031–2036.
- de Jesús GR, d'Oliveira ICC, dos Santos FC, et al. Pregnancy may aggravate arterial hypertension in women with Takayasu arteritis. Isr Med Assoc J. 2012; 14(12): 724–728.
- Miyasaka N, Egawa M, Isobe M, et al. Obstetrical management of patients with extra-anatomic vascular bypass grafts due to Takayasu arteritis. J Obstet Gynaecol Res. 2016; 42(12): 1864–1869.
- Hall S, Buchbinder R. Takayasu's arteritis. Rheum Dis Clin North Am. 1990; 16(2): 411–422.
- Kerr GS, Hallahan CW, Giordano J, et al. Takayasu arteritis. Ann Intern Med. 1994; 120(11): 919–929.
- Mwipatayi BP, Jeffery PC, Beningfield SJ, et al. Takayasu arteritis: clinical features and management: report of 272 cases. ANZ J Surg. 2005; 75(3): 110–117.
- Hauenstein E, Frank H, Bauer JS, et al. Takayasu's arteritis in pregnancy: review of literature and discussion. J Perinat Med. 2010; 38(1): 55–62.
- Seyahi E. Takayasu arteritis: an update. Curr Opin Rheumatol. 2017; 29(1): 51–56.
- Comarmond C, Mirault T, Biard L, et al. French Takayasu Network. Takayasu Arteritis and Pregnancy. Arthritis Rheumatol. 2015; 67(12): 3262–3269.
- Lee EH, Choi E, Ahn W. Application of cerebral oximetry for a parturient with Takayasu's arteritis undergoing cesarean section -a case report-. Korean J Anesthesiol. 2013; 65(2): 158–162.
- Mirault T, Messas E. Takayasu arteritis. Rev Med Interne. 2016; 37(4): 223–229.
- Soh MC, Nelson-Piercy C, Soh MC, et al. High-risk pregnancy and the rheumatologist. Rheumatology (Oxford). 2015; 54(4): 572–587.
- Ishikawa K, Maetani S. Long-term outcome for 120 Japanese patients with Takayasu's disease. Clinical and statistical analyses of related prognostic factors. Circulation. 1994; 90(4): 1855–1860.
- Xiao W, Wang T, Fu W, et al. Regional cerebral oxygen saturation guided cerebral protection in a parturient with Takayasu's arteritis undergoing cesarean section: a case report. J Clin Anesth. 2016; 33: 168–172.
- Sharma BK, Jain S, Vasishta K. Outcome of pregnancy in Takayasu arteritis. Int J Cardiol. 2000; 75 Suppl 1: 159–162.
