Takayasu's arteritis and pregnancy: a case of deleterious association

Takayasu’s Arteritis in Pregnancy: A Rare Case Report

The aorta and its main branches are affected by the uncommon systemic vasculitis known as Takayasu's arteritis (TA). The gradual onset of the disease and early, very generalised symptoms may factor in the large delay in diagnosis and treatment. This is an interesting case report of a patient with the rare condition of TA, who was unaware of her disease. Her ailment was diagnosed during antenatal examination, and this report speaks of her further imminent management without any adverse effects on maternal or foetal outcomes. To enhance maternal and foetal prognosis, gynaecologists, cardiologists, radiologists, and neurologists must work together collaboratively. Here is a case study of a woman who had TA and bravely defied the condition's whims to give birth without issue.

Takayasu's arteritis in pregnancy: review of literature and discussion

Takayasu's arteritis (TA) is a rare inflammatory disease of the arteries that affects women of childbearing age. The optimal management for pregnant patients with this disease has not yet been defined. The course of disease seems to be neither affected nor worsened by pregnancy. We could not find reported maternal deaths directly related to pregnancy. However, many authors report maternal as well as fetal unfavorable events in the course of pregnancy. We describe a 25-year-old primigravida of Turkish-Greek origin who presented at 30 weeks of pregnancy with active TA. In the 37(th) week, intrauterine fetal death occurred. Our patient did not show high blood pressure or aortic inflammation. The course of her disease was stable. Whether a newly diagnosed TA during pregnancy should be regarded as an indication for premature delivery is discussed. An interdisciplinary collaboration of rheumatologists, nephrologists and obstetricians is necessary to improve maternal and fetal prognosis.

A successful pregnancy in a patient with Takayasu's arteritis

Takayasu's arteritis is a chronic, idiopathic, inflammatory disease of the arteries, which primarily involves the aorta, its main branches such as the brachiocephalic, carotid, subclavian, vertebral, and renal arteries, as well as the coronary and pulmonary arteries. It has been suggested that pregnancy, although not usually associated with an exacerbation of inflammatory vascular lesions, should only be considered during a phase of remission. The increased intravascular volume seen during pregnancy may impair circulation and exacerbate aortic regurgitation, hypertension, and congestive heart failure. Hypertension is probably the most serious major complication that can develop, possibly leading to intrauterine growth retardation, maternal heart failure, and fetal haemorrhage. We describe the case of a patient with a 7-year history of Takayasu's arteritis who conceived against medical advice. She continued to take her prescribed medication throughout the pregnancy, including adalimumab, leflunomide (until 8 weeks' gestation), and prednisolone. She underwent a planned cesarean section under spinal anesthesia at 37 + 2 weeks' gestation, and a healthy baby boy weighing 2550 g was delivered. There were no postpartum complications.

Pregnancy and vasculitis

Until recently, the prognosis associated with many forms of systemic vasculitis was quite grim. Advances in this field have allowed us to begin to focus on issues related to quality of life such as fertility, conception, and pregnancy among women with vasculitis. Because the systemic vasculitides are rare diagnoses, many important questions remain unanswered. Overall, it seems that women who have inactive vasculitis may not be subject to unusual complications during pregnancy, but our understanding of the interaction between pregnancy and specific forms of vasculitis continues to evolve.

Successful use of deep hypothermic circulatory arrest in pregnancy

A woman pregnant for 21 weeks underwent an emergency operation because of an aortic arch aneurysm that had ruptured into her left lung. Cardiopulmonary bypass and deep hypothermia were used and she needed 37 minutes of circulatory arrest at a core temperature of 19 degrees C. Both the mother and fetus survived, and a normal baby was delivered by cesarean section at the 39th week of gestation.

Clinical gynecologic features of pregnancy in Takayasu arteritis

Takayasu arteritis is a non-specific chronic inflammatory vascular disease of unknown etiology. Since the incidence of this disease in the child-bearing years is relatively high, the management of pregnancies with this disease is of great importance in clinical obstetrics. This study is aimed at discussing the maternal management and obstetrical outcome, based on the clinical data obtained from 23 pregnancies of 15 patients treated in our hospital in the past 12 years. Since the disease was in the active state, artificial abortions were conducted in four cases in the 1st trimester of pregnancy. Among the remaining 16 cases, 3, who exhibited neither hypertension nor other complications, vaginally delivered neonates weighing 2,660-3,100 g with Apgar scores of nine after 37 weeks' gestation. C-sections were performed for 13 patients who showed sustained hypertension or/and developed other vascular disorders. Their gestational periods ranged from 34 to 40 weeks and the body weight of the infants varied from 1,425 to 3,024 g. No adverse influence of pregnancy and delivery on Takayasu arteritis was detected in the puerperium of any patients. It is suggested that the state of Takayasu arteritis in early pregnancy and the magnitude of blood pressure elevation in the late gestational period are the most critical and definitive factors in determining the management of pregnancy of a patient with Takayasu arteritis. Cooperative managements by the specialists in obstetrics, internal medicine, and perinatology are required to provide a satisfactory clinical outcome.