Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

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.

Pregnancy Morbidities in Korean Patients with Takayasu Arteritis: A Monocentric Pilot Study

“…We searched for previous studies investigating the pregnancy outcomes in patients with TA, and summarized their findings in Table 4 . 6 7 14 15 16 17 18 The median maternal age in this study was 32.0 years, which was higher than the median or mean maternal ages in the previous studies (range: 25.1 to 31.0 years). Although our results are limited by the small sample size of this study, it could be explained by the socioeconomic aspect considering that the mean age of conception was the highest in Korea among the Organization for Economic Cooperation and Development (OECD) nations.…”

Disease activity assessment of rheumatic diseases during pregnancy: a comprehensive review of indices used in clinical studies

“…Nevertheless, items such as ESR and musculoskeletal symptoms can be influenced by pregnancy, so they should be interpreted with caution. Furthermore, most of the studies [3,84,[88][89][90][91][92][93] took into account the general characteristics of the subjects (age, type of arterial involvement, parity, previous obstetric complications), maternal outcomes (glucocorticoid dose increase, CRP and ESR, arterial hypertension, PE, renal and cardiac failure, cardiovascular events), fetal and neonatal outcomes (FGR, prematurity, birth weight, perinatal mortality, Apgar score at 5 min) [3,84,[88][89][90][91][92][93][94][95].…”

“…Pregnancy does not seem to affect disease activity in TA patients [80], nevertheless, maternal complications such as sustained hypertension, PE, congestive heart failure and cerebrovascular accidents are not uncommon [3,84,[88][89][90][91][92][93][94][95][96].…”

Pregnancy with active Takayasu’s arteritis: A medical challenge

“…Takayasu arteritis is a disease of unknown pathology which is more common in females with a ratio of 1:4 [3]. There are hormonal, genetic, infective, immune-mediated, and other mechanisms to explain the pathophysiology of this disease [5,6]. One of the theories suggests association and causation with hormones like estrogen and progesterone which explains its incidence in the young female population [6].…”

“…It mainly affects young women of childbearing age usually distributed in Southeast Asia, areas of Africa, and Southern hypertension, organ dysfunction, restricted intrauterine fetal growth, and low birth weight [2][3][4][5]. Here we discuss the management of a pregnant female with active TA, with limited published literature on same.…”