Management and evaluation of pregnant women with Takayasu arteritis
- 257 Downloads
To evaluate the clinical characteristics, obstetric/neonatal outcomes, and pregnancy complications of pregnant women with Takayasu arteritis (TA).
We retrospectively evaluated the data of 22 pregnancies of 11 patients with TA between January 1 2000, and December 31 2017. Patient characteristics, severity of disease, obstetric outcomes, pregnancy complications, mode of delivery, and neonatal outcomes were evaluated.
Based on the angiographic classification, four, two, one, three, and one patient were classified into groups I, IIa, III, IV, and V, respectively. Based on Ishikawa criteria, five, two, two, and two patients were classified into groups 2a, 1, 2b, and 3, respectively. Sixteen and five pregnancies resulted in live births and spontaneous abortion, respectively. One pregnancy was terminated due to prenatally diagnosed trisomy 21. Relapse of TA was observed in five pregnancies. Mean age at diagnosis was 24.54 ± 6.23 years, and mean age at conception was 30.30 ± 4.80 years. There were two multiple pregnancies (one twin and one triplet) and 19 newborns were delivered alive. Rates of hypertensive disorders of pregnancy, preterm birth, intrauterine growth retardation, oligohydramnios, and intrauterine fetal demise were 36.4, 18.2, 13.6, 13.6, and 0%, respectively. Mean gestational age at birth was 37.25 ± 2.40 weeks and mean birthweight was 2682.10 ± 176.82 g. Median APGAR score was 8. Cesarean section rate was 50%. Regional anesthesia/analgesia was administered during 62.5% of the deliveries. Ten neonates were admitted to neonatal intensive care unit and eight neonates had neonatal respiratory complications.
Appropriate management of pregnant women with TA within the framework of antenatal care programs and adopting a multidisciplinary approach are key to ensure successful outcomes.
KeywordsTakayasu arteritis Pregnancy Obstetric outcomes Antenatal care program
Oue special thanks are due to rheumatology, cardiology, and neonatology divisions for their efforts in providing the patients with optimal health care.
AT: project development, data collection, data analysis, and manuscript writing; CU: data collection, data analysis, and manuscript writing; HMY: data collection and manuscript writing; SAD: data collection and manuscript writing; MSB: project development and manuscript writing.
No funding was used for this study.
Compliance with ethical standards
Conflict of interest
Atakan Tanacan declares that he has no conflict of interest. Canan Unal declares that she has no conflict of interest. Halise Meltem Yucesoy declares that she has no conflict of interest. Sinem Ayse Duru declares that she has no conflict of interest. Mehmet Sinan Beksac declares that he has no conflict of interest.
The study protocol was approved by Hacettepe University Ethics Committee (GO 18/68).
Informed consent was obtained from all individual participants included in the study.
- 10.Craven A, Robson J, Ponte C, Grayson PC, Suppiah R, Judge A, Watts R, Merkel PA, Luqmani RA (2013) ACR/EULAR-endorsed study to develop diagnostic and classification criteria for vasculitis (DCVAS). Clin Exp Nephrol 17(5):619–621. https://doi.org/10.1007/s10157-013-0854-0 CrossRefPubMedGoogle Scholar
- 11.Matsuura K, Ogino H, Kobayashi J, Ishibashi-Ueda H, Matsuda H, Minatoya K, Sasaki H, Bando K, Niwaya K, Tagusari O, Nakajima H, Yagihara T, Kitamura S (2005) Surgical treatment of aortic regurgitation due to Takayasu arteritis: long-term morbidity and mortality. Circulation 112(24):3707–3712. https://doi.org/10.1161/circulationaha.105.535724 CrossRefGoogle Scholar
- 13.Miyata T, Sato O, Koyama H, Shigematsu H, Tada Y (2003) Long-term survival after surgical treatment of patients with Takayasu’s arteritis. Circulation 108(12):1474–1480. https://doi.org/10.1161/01.cir.0000089089.42153.5e CrossRefPubMedGoogle Scholar
- 14.Kirshenbaum M, Simchen MJ (2017) Pregnancy outcome in patients with Takayasu’s arteritis: cohort study and review of the literature. J Matern Fetal Neonatal Med 31:1–7Google Scholar
- 27.Beksac K, Orgul G, Can GS, Oktem A, Kav T, Beksac MS (2017) Management of inflammatory bowel disease and pregnancy using prophylactic low dose low molecular weight heparin and corticosteroids. J Clin Diagn Res 11(11):1–3Google Scholar