Pregnancy in Takayasu arteritis - maternal and fetal outcome

Garikapati, Kavitha; Kota, Lakshmi Narayana; Kodey, Prabha Devi

doi:10.18203/2320-1770.ijrcog20162628

Cited by 4 publications

(12 citation statements)

References 21 publications

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“…Since this condition is predominantly seen in young women, it is not uncommon to come across pregnant women with TA. 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).…”

Section: Discussionsupporting

confidence: 88%

“…Although most of our women had type 5 TA, the severity of complications in terms of hypertension and superimposed preeclampsia was much lower than those mentioned by some others (7), since most of our women had already undergone treatment for the underlying disease prior to embarking upon pregnancy. Four of our patients with type 5 TA underwent PTA prior to pregnancy.…”

Section: Discussioncontrasting

confidence: 55%

“…There have been many theories postulated for this such as an immunomoduatory effect of progesterones, release of cytokines by helper T cells and immunologic changes seen in pregnancy as part of an adaptive process (4,21,22). However it is associated with poor perinatal outcome, especially in patients with complicated disease and relapses (6)(7)(8)23).…”

Section: Discussionmentioning

confidence: 99%

“…This often results in aortic regurgitation (AR) and congestive heart failure. Vasoconstriction also leads to chronic uteroplacental insufficiency, resulting in worsening of pre-existing hypertension superimposed pre eclampsia and/or fetal growth restriction (6,7).…”

Section: Introductionmentioning

confidence: 99%

“…There is a lack of recognized robust guidelines for management of such pregnancies and much of the evidence available in the medical literature is in the form of case series or case reports (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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

David

Beck

Kumar

et al. 2020

J Turkish German Gynecol Assoc

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To study obstetric and perinatal outcomes among pregnant women with Takayasu arteritis (TA), attending our hospital for pregnancy and childbirth between January 2011 to December 2016. Material and Methods: Retrospective study was carried out by abstracting clinical charts on all pregnant women with TA who underwent antenatal care and/or delivery in our hospital during this period. American College of Rheumatology criteria was used for diagnosis of TA. Sixteen women with TA were included in the study. Maternal demographic data, stage of disease, complications related to disease, details of treatment taken prior to pregnancy, pregnancy outcomes, and neonatal outcomes were studied. Results: Forty-four percentage (7/16) belonged to type 5 angiographic type, however the same proportion (7/16) had undergone surgical corrections prior to pregnancy and the majority (15/16) were on medical management. Only three women (19%) were diagnosed during pregnancy. Most did not have active disease measured by Kerr's criteria (n=12; 75%), and Indıan Takayasu clinical activity scores A. Chronic hypertension was the commonest antenatal complication (56.2%), nearly one-third had growth restricted babies and 25% had preterm labour. There were no cardiovascular events, no maternal deaths, nor fetal or neonatal deaths. Two-thirds of our women were delivered by caesarean section. Conclusion: Preconceptional counselling is of paramount importance in women with TA. Good maternal and fetal outcomes are observed with close antenatal surveillance and multidisciplinary care. Pregnancy should be planned during disease remission, with good antenatal care, close monitoring of clinical symptoms, early diagnosis and treatment of complications.

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Section: Discussionsupporting

confidence: 88%

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

David

Beck

Kumar

et al. 2020

J Turkish German Gynecol Assoc

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Women Issues in Autoimmune Diseases: Compilation of Indian Data

Bhojani¹

2020

Women's Health in Autoimmune Diseases

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Pregnancy in Takayasu’s arteritis has a high risk of hypertension‐related fetomaternal complications: A retrospective study of a Turkish cohort

et al. 2021

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Background This study aimed to examine fetomaternal outcomes in pregnant women in a large Turkish Takayasu arteritis (TAK) cohort and to evaluate the effects of pregnancy on the disease in those patients. Methods This is a cohort study involving 296 pregnancies of 112 TAK patients from 8 tertiary rheumatology centers in Turkey. Pregnancies were divided into 2 groups as pre‐d (before disease onset) and post‐d (after disease onset). In addition, post‐d pregnancies were further divided into 2 subgroups according to fetomaternal complications (FMC) development status. Finally, patients were grouped into those with and without a history of pregnancy after disease onset. Results In post‐d pregnancies, rates of worsening hypertension, new‐onset hypertension, and preeclampsia were higher than in pre‐d pregnancies (0.9% vs 16%, P < .001, 0.5% vs 5.3%, P = .012, and 0% vs 4%, P = .013, respectively). Patients with FMC were more likely to have renal artery involvement (65% vs 21%, P = .003). The patients who had post‐d were younger, had longer disease duration, and had more relapses number than other patients (P < .001, P = .028, P = .016, respectively). Vasculitis Damage Index (VDI) results were similar in patients with or without post‐d pregnancies. Conclusion Pregnancies after disease onset were found to be associated with HT and preeclampsia/eclampsia. HT‐related FMCs are increased in TAK, and patients with renal artery involvement are at higher risk. The number of relapses increases in patients who become pregnant after disease onset, but pregnancy was not an independent risk factor for relapse. Pregnancy after the onset of disease had no negative effect on VDI.

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Pregnancy in Takayasu arteritis - maternal and fetal outcome

Cited by 4 publications

References 21 publications

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

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

Women Issues in Autoimmune Diseases: Compilation of Indian Data

Pregnancy in Takayasu’s arteritis has a high risk of hypertension‐related fetomaternal complications: A retrospective study of a Turkish cohort

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