Maternal and fetal outcomes in pregnant women with Takayasu aortoarteritis: Does optimally timed intervention in women with renal artery involvement improve pregnancy outcome?

Abstract

Patients with renovascular involvement without intervention are at high risk of having maternal and fetal complications. Early intervention prior to conception in these women is recommended to prevent pregnancy complications.

Obstetric and perinatal outcomes in pregnant women with Takayasu’s arteritis: single centre experience over five years

“…The most common cause for fetal growth restriction was the presence of maternal hypertension, leading to uteroplacental insufficiency. Similar findings were noted previously by other authors (6)(7)(8)10,18,25). Women who had stenting and surgical corrections prior to pregnancy had well grown babies.…”

“…In addition women with TA are more likely to become pregnant than other forms of vasculitis, since TA does not affect fertility (2,6,7). Mean age of diagnosis in our cohort was 24 years which was similar to other previous reports (18,19). Most of our patients were in the second decade of life as is classically described in the literature (2).…”

“…AR was the most significant cardiac problem as has been reported previously (7,18). In our cohort, two women had severe pre-pregnancy AR, with one being on anti-cardiac failure drugs.…”

“…Garikapati et al 7observed hypertension in 90% of their patients. In another similar study Singh et al (18) found hypertension in 90% of patients with renal involvement. This however dropped to 50% following treatment for underlying pathology.…”

“…Unfortunately, this is not an uncommon scenario in the developing world where women do not have easy access to specialized health care .These women were diagnosed in the last trimester of pregnancy, one after 32 weeks when she first presented to our hospital, other two at 40 weeks when they presented in labour, and was incidently found to have diminished pulse in one limb. Singh et al (18) showed that early assessment of disease status prior to conception and effective intervention prior to embarking on pregnancy, resulted in successful pregnancy outcomes. Other studies have noted increased rates of abortions in these women (24,25).…”