DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20192469

Pregnancy in a rare case of Takayasu’s arteritis: a case report

Kushal Shah, Vaishali Korde Nayak

Abstract


In Takayasu’s arteritis is a rare, chronic idiopathic vasculitis affecting aorta and its major branches, commonly seen in young women of Asian origin. Incidence is 2.6 cases/million/year. Female of reproductive age group are commonly affected. A 32-year female G3A2 with known case of Takayasu arteritis wanted to continue this pregnancy under tremandous social pressure and came for antenatal care at tertiary care hospital. As the pregnancy advanced, she developed uncontrolled hypertension and severe IUGR. At 30 weeks of gestation, elective LSCS had to be done in view of reduced fetal blood flow and severe growth restriction. She delivered male baby of 1 kg which was shifted to NICU. Patient required cardiac intensive care unit for first 48 hrs and later shifted to ward. Postoperative period was uneventful, and patient could be discharged on 8th day. Baby received intensive NICU care and discharged after 1 month with 2 kg weight. Pregnancy with takayasu arteritis requires a multipronged management from gynaecologist, cardiologist, cardiac anaesthetist and neonatologist for favourable maternal and fetal outcome.


Keywords


Fetal growth restriction, Pregnancy, Pulseless disease, Takayasu arteritis, Uncontrolled hypertension

Full Text:

PDF

References


Lupi-Herrera E, Sánchez-Torres G, Marcushamer J. Takayasu arteritis. Clinical study of 107 cases. Am Heart J. 1977;93:94-103.

Hall S, Barr W, Lie JT, Stanson AW, Kazmier FJ, Hunder GG. Takayasu arteritis. A study of 32 North American patients. Medicine. 1985;64(2):89-99.

Takayasu M. A case with peculiar changes of the retinal central vessels. Acta Opthalmic Soc Japan. 1908;12:554-5.

Numano F, Okawara M, Inomata H. Takayasu's arteritis. Lancet. 2000;356:1023-5.

Khraishi MM, Gladman DD, Dagenais P, Fam AG, Keystone EC. HLA antigens in North American patients with Takayasu arteritis Arthritis Rheum. 1992;35(5):573-5.

Wen D, Du X, Ma CS. Takayasu arteritis: diagnosis, treatment and prognosis. Int Rev Immunol. 2012;31(6):462-73.

Krishna MV, Rudresh NS. Takayasu’s arteritis-Stroke as an initial presentation. JIACM. 2004;5(3):274-6

Moriwaki R, Moda M, Yajima M. Clinical manifestations of Takayasu’s arteritis in India and Japan-new classification of angiographic findings. Angiol. 1997;48:369-79.

Ishikawa K. Natural history and classification of occlusive thromboaortopathy (Takayasu's disease). Circulation. 1978;57:27-35.

Sharma BK, Jain S, Vasishta K. Outcome of pregnancy in Takayasu arteritis. Int J Cardiol. 2000;75:S159-62.