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Clinical manifestations of pregnancy in patients with Takayasu arteritis: experience from a single tertiary center

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

Takayasu arteritis predominantly affects young women of reproductive age; therefore, the management of pregnancies with this disease is of great importance in clinical obstetrics. However, only a limited number of such cases have been reported in the English literature. Our aim in this study was to investigate the clinical features of pregnant women with Takayasu arteritis managed at a tertiary center in Japan.

Methods

We conducted a retrospective study of 26 pregnancies (18 deliveries) in 10 women with Takayasu arteritis, who were managed at Kyushu University Hospital between 1996 and 2010. Data were collected retrospectively by reviewing the maternal medical records.

Results

The mean age of these patients at delivery was 29.3 ± 5.2 years. Six patients had lesions above and below the diaphragm, and four patients showed isolated supradiaphragmatic disease. Echocardiography was performed in all patients, and aortic regurgitation was observed in six. Five pregnancies resulted in spontaneous abortion, and three pregnancies were legally terminated at the patients’ request. The remaining 18 pregnancies resulted in live births. Of the 18 live babies born, growth restriction was observed in 2 babies. Superimposed pregnancy-induced hypertension was observed in two cases, and other severe complications, such as cerebral hemorrhage or cardiac failure did not occur.

Conclusion

Although Takayasu arteritis is a potentially severe condition during pregnancy, successful pregnancy is possible if extreme caution is followed. Blood pressure should be strictly controlled and the delivery should be planned for favorable maternal and fetal outcomes.

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References

  1. Hunter S, Robson SC (1992) Adaptation of the maternal heart in pregnancy. Br Heart J 68:540–543

    Article  PubMed  CAS  Google Scholar 

  2. Robson SC, Dunlop W, Boys RJ, Hunter S (1987) Cardiac output during labour. Br Med J 7:1169–1172

    Article  Google Scholar 

  3. Ishikawa K, Matsuura S (1982) Occlusive thromboaortopathy (Takayasu’s disease) and pregnancy. Clinical course and management of 33 pregnancies and deliveries. Am J Cardiol 50:1293–1300

    Article  PubMed  CAS  Google Scholar 

  4. Wong VCW, Wang RYC, Tse TF (1983) Pregnancy and Takayasu’s arteritis. Am J Med 75:597–601

    Article  PubMed  CAS  Google Scholar 

  5. Aso T, Abe S, Yaguchi T (1992) Clinical gynecologic features of pregnancy in Takayasu arteritis. Heart Vessels 7:125–132

    Article  CAS  Google Scholar 

  6. Sharma BK, Jain S, Vasishta K (2000) Outcome of pregnancy in Takayasu arteritis. Int J Cardiol 75:159–162

    Article  Google Scholar 

  7. Suri V, Aggarwall N, Keepanasseril A, Chopra S, Vijayvergiya R, Jain S (2010) Pregnancy and Takayasu arteritis: a single centre experience from North India. J Obstet Gynaecol Res 519–524

  8. Ogawa Y, Iwamura T, Kuriya N, Nishida H, Takeuchi H, Takada M, Itabashi K, Imura S, Isobe K (1998) Birth size standards by gestational age for Japanese neonates. Acta Neonatol Jap 34:624–663 (in Japanese)

    Google Scholar 

  9. Nakazawa M (2005) Guidelines for indication and management of pregnancy and delivery in women with heart disease (JCS 2005). Circ J 69(Supply IV):1267–1320 (in Japanese)

    Google Scholar 

  10. Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977) Takayasu’s arteritis. Clinical study of 107 cases. Am Heart J 93:94–103

    Article  PubMed  CAS  Google Scholar 

  11. Isselbacher EM (1997) Diseases of the aorta: aortoarteritis syndromes. In: Braunwald E (ed) Heart disease: a textbook of cardiovascular medicine, 5th edn. WB Saunders, Philadelphia, pp 1572–1575

    Google Scholar 

  12. Matsuura A, Moriwaki R, Numano F (1992) Pregnancy in Takayasu arteritis from the view of internal medicine. Heart Vessels Suppl 7:120–124

    Article  Google Scholar 

  13. Burton RM (1966) Pulseless disease. J Obstet Gynaecol Br Commonw 73:113–118

    Article  PubMed  CAS  Google Scholar 

  14. Hauth JC, Cunningham FG, Young BK (1977) Takayasu’s syndrome in pregnancy. Obstet Gynecol 50:373–375

    PubMed  CAS  Google Scholar 

  15. Umeda Y, Mori Y, Takagi H, Iwata H, Fukumoto Y, Hirose H (2004) Abdominal aortic aneurism related to Takayasu arteritis during pregnancy. Heart Vessels 19:155–156

    Article  PubMed  Google Scholar 

  16. Tomioka N, Hirose K, Abe E, Miyamoto N, Araki K, Nomura R, Ishikawa K (1998) Indications for peripartum aortic pressure monitoring in Takayasu’s disease. A patient with past history of intrapartum cerebral hemorrhage. Jpn Heart J 39:255–260

    Article  PubMed  CAS  Google Scholar 

  17. Vaysee C, Touboul C, Vaysee N, Deichier MC, Vayssiere C (2009) In utero fetal death in pregnancy complicated by Takayasu’s arteritis: case report and review. J Gynecol Obstet Biol Reprod 38:595–598 (in French)

    Article  Google Scholar 

  18. Hauenstein E, Frank H, Bauer JS, Schneider KT, Fischer T (2010) Takayasu’s arteritis in pregnancy: review of literature and discussion. J Perinat Med 38:55–62

    Article  PubMed  Google Scholar 

  19. Ioscovich A, Gislason R, Fadeev A, Grisaru-Granovsky S, Halpern S (2008) Peripartum anesthetic management of patients with Takayasu’s arteritis: case series and review. Int J Obstet Anesth 17:358–364

    Article  PubMed  CAS  Google Scholar 

  20. Henderson K, Fludder P (1999) Epidural anaesthesia for caesarean section in a patient with severe Takayasu’s disease. Br J Anaesth 83:956–959

    PubMed  CAS  Google Scholar 

  21. Beilin Y, Bernstein H (1993) Successful epidural anaesthesia for a patient with Takayasu’s arteritis presenting for caesarean section. Can J Anaesth 40:64–66

    Article  PubMed  CAS  Google Scholar 

  22. Lakhi NA, Jones J (2010) Takayasu’s arteritis in pregnancy complicated by peripartum aortic dissection. Arch Gynecol Obstet 282:103–106

    Article  PubMed  Google Scholar 

  23. Immer FF, Bansi AG, Immer-Bansi AS, McDougall J, Zehr KJ, Schaff HV, Carrel TP (2003) Aortic dissection in pregnancy: analysis of risk factors and outcome. Ann Thorac Surg 76:309–314

    Article  PubMed  Google Scholar 

  24. Lipscomb KJ, Smith JC, Clarke B, Donnai P, Harris R (1997) Outcome of pregnancy in women with Marfan’s syndrome. Br J Obstet Gynaecol 104:201–206

    Article  PubMed  CAS  Google Scholar 

  25. Rossiter JP, Repke JT, Morales AJ, Murphy EA, Pyeritz RE (1995) A prospective longitudinal evaluation of pregnancy in the Marfan syndrome. Am J Obstet Gynecol 173:1599–1606

    Article  PubMed  CAS  Google Scholar 

  26. Task Force on the Management of Cardiovascular Diseases During Pregnancy of the European Society of Cardiology: Expert consensus document on management of cardiovascular diseases during pregnancy. Eur Heart J 2003;24:761–781

    Google Scholar 

  27. Weiss BM, Zemp L, Seifert B, Hess OM (1998) Outcome of pulmonary vascular disease in pregnancy: a systemic overview from 1978 through 1996. J Am Coll Cardiol 31:1650–1657

    Article  PubMed  CAS  Google Scholar 

  28. Jacquemyn Y, Vercauteren M (2005) Pregnancy and Takayasu’s arteritis of the pulmonary artery. J Obstet Gynaecol 25:63–65

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Nobuhiro Hidaka.

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Hidaka, N., Yamanaka, Y., Fujita, Y. et al. Clinical manifestations of pregnancy in patients with Takayasu arteritis: experience from a single tertiary center. Arch Gynecol Obstet 285, 377–385 (2012). https://doi.org/10.1007/s00404-011-1992-9

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  • DOI: https://doi.org/10.1007/s00404-011-1992-9

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