Analysis of pregnancies in women with Takayasu arteritis: Complication of Takayasu arteritis involving obstetric or cardiovascular events

Abstract

Pregnant women without active Takayasu arteritis have a low risk of developing a cardiovascular event. For women with chronic hypertension, it might be important to note the development of pre-eclampsia, fetal growth restriction and abruption.

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

“…Owing to the increase in blood volume, BP can further increase during pregnancy, thus causing preeclampsia, heart failure, cerebrovascular accident, or even death; the placental blood flow will also be affected, causing limited fetal growth or even fetal death [5][6][7]. At present, most scholars believe that patients with pre-pregnancy TA in the stable stage will have a better prognosis [6,8,9]. Conversely, some scholars also believe that there is no significance in the risk of maternal and fetal complications; however, the incidence of such complications is higher in these patients than in normal populations.…”

“…However, owing to the small number of cases, we still need to accumulate such cases further for observation. The risk of glucocorticoids toward mothers is that the body will be in the immunosuppressed state; thus, pregnant women are prone to infection and consequently to gestational diabetes (when combined with insulin resistance increase) [9,20], osteoporosis, pathological fractures, hypokalemia, gastrointestinal bleeding, intraocular pressure increase, or other adverse reactions. Glucocorticoids also need to be administered together with appropriate supplementation of vitamin D, Ca 2+ , or K + , as well as electrolyte level, gastrointestinal reaction, or intraocular pressure monitoring.…”

“…As such, we focused on whether patients with TA can conceive and on how to manage the mother and child to achieve good outcomes [8]. According to previous case reports, TA may occur with hypertensive disorders, heart failure, cerebrovascular accidents, fetal growth restriction, or even fetal death during pregnancy [5][6][7][8][9][10]. Previously, the understanding of pregnancy related to TA mainly comes from domestic and foreign case reports or small-number case reports, in which most cases are in the stable stage; the number of cases in the active stage is low; and cases delivering in the active stage are even rare.…”

“…Previously, the understanding of pregnancy related to TA mainly comes from domestic and foreign case reports or small-number case reports, in which most cases are in the stable stage; the number of cases in the active stage is low; and cases delivering in the active stage are rare. TA may occur with peri-pregnancy hypertension, heart failure, cerebrovascular accidents, fetal growth restriction, or even fetal death [5][6][7][8][9][10]; thus, we focused on whether patients with TA can conceive and on how to manage the mother and child to achieve good outcomes [8]. There has been no systematic and effective report regarding peri-pregnancy monitoring or www.…”

Pregnancy in Takayasu Arteritis Patients Exposed to Anti-Tumour Necrosis Factor (Anti-TNF)-α Therapy

“…Furthermore, maternal complications, including arterial hypertension, pre-eclampsia and cardiovascular involvement can impact on maternal and fetal outcomes. 5 Relatively few TA pregnancies have been described without consensus on the optimal management of disease during pregnancy.…”