Obstetrical management of patients with extra‐anatomic vascular bypass grafts due to Takayasu arteritis

Matsuda, Naoyuki; Egawa, Makiko; Isobe, Mitsuaki; Inoue, Yasuhiro; Kubota, Toshiro

doi:10.1111/jog.13139

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…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. There has been no systematic and effective report regarding peri-pregnancy monitoring or specific treatment measures targeting patients with TA [11]; we used convenient and effective peri-pregnancy treatment and monitoring measures and achieved satisfactory maternal and fetal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…There has been no systematic and effective report regarding peri-pregnancy monitoring or www. journals.viamedica.pl/ginekologia_polska specific treatment measures targeting patients with TA [11]; therefore, to determine convenient and effective peri-pregnancy treatment measures and monitoring means, we summarized the data of 13 pregnancy complicated with Takayasu arteritis (P-TA) cases treated in our hospital, including seven cases in the active stage of TA, and provided specific and feasible advice for their pregnancy monitoring and relevant management to achieve good maternal and fetal outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Zhang¹,

Li²,

Zhang³

2017

Ginekol Pol

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Objectives: To investigate the clinical features, disposition, and effect of pregnancy complicated with Takayasu arteritis (P-TA) on maternal and fetal outcomes. Material and methods:The clinical data (diagnosis and treatment, peri-pregnancy monitoring, and pregnancy outcomes) of patients with P-TA treated in our hospital between September 2007 and April 2016 were analyzed retrospectively.Results: Among the 13 P-TA cases, seven were diagnosed before pregnancy, and six were diagnosed during pregnancy; six cases were diagnosed as the generalized type, and seven cases were diagnosed as the cephalic-brachial type; six cases were in the stable stage, and seven cases were in the active stage. All the cases in the active stage underwent glucocorticoid therapy. Four cases developed complications, including cardiac dysfunction combined with preeclampsia in two cases, preeclampsia in one case, and stroke in one case. Eleven patients successfully delivered (nine cases of full-term delivery and two cases of premature delivery); one patient had late miscarriage; one patient had missed abortion. All the parturients survived and delivered 11 neonates (nine full-term neonates and two premature neonates) and one low-birth-weight neonate; no neonatal asphyxia or death occurred. Conclusions:Patients with P-TA can have better maternal and child outcomes through timely diagnosis and treatment, dynamic monitoring, or timely pregnancy termination.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Zhang¹,

Li²,

Zhang³

2017

Ginekol Pol

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“…118 Similarly to other RDs, active disease prior to and during pregnancy significantly increases the risk of maternal morbidity -most commonly new-onset or worsening hypertension -and various APOs. 119 While women with Takayasu's can have successful pregnancies, 15,120 disease-related vascular damage may increase the risk of poor outcomes, even in the absence of active disease. 121,122 In general, disease activity immediately preceding or during pregnancy is likely the most significant risk factor for APOs.…”

Section: Other Rheumatic Diseasesmentioning

confidence: 99%

Challenges in Family Planning and Pregnancy for Women with Rheumatic Diseases

Siegel¹,

Sammaritano²

2023

Rheumatology

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Systemic rheumatic diseases (RDs) often affect women in their reproductive years and may complicate family planning and pregnancy. For women with RD who are not pursuing pregnancy, especially those at the highest risk of maternal morbidity or on teratogenic medications, effective contraception is important. For women with active systemic lupus erythematosus (SLE) and/or antiphospholipid antibodies, oestrogen-containing contraceptive methods are generally not recommended. Emergency contraception and induced abortion are safe for women with RD and should be discussed when clinically appropriate. Women with RD commonly have questions and concerns about the impact of their disease on fertility and conception. RD-associated factors may contribute to difficulties in conceiving and decreased family size. Assisted reproductive technology (ART) is often a safe option for women with RD. However, precautions and specific treatment modifications may be needed, particularly in women with SLE and/or antiphospholipid antibody positivity. SLE and antiphospholipid syndrome (APS) are the RDs associated with the greatest risk of maternal and foetal pregnancy complications. Regardless of the specific RD, having an active disease is a significant risk factor for poor pregnancy outcomes. With appropriate preconception planning and multidisciplinary management during and after pregnancy, most women with RD can have successful pregnancies.

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“…11,13 No systematic reports or guidelines exist on monitoring pregnant TA patients and their treatment before, during, and after pregnancy. 14 Unanswered questions include the risk factors for adverse obstetric outcomes and the effect of immunosuppressive drugs, aspirin, and antihypertensive medications on pregnancy outcomes. 15 As a result, we summarised the data from 19 pregnancies of 10 patients complicated by TA to determine convenient and effective peri-pregnancy treatment measures and monitoring methods.…”

Section: Introductionmentioning

confidence: 99%

Maternal and fetal outcomes in pregnant women with Takayasu’s arteritis: single center experience over ten years

YAĞIZ,

COŞKUN,

SAKAR

et al. 2023

Turkish Journal of Internal Medicine

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Background: This study aims to assess pregnant women's maternal and fetal outcomes with Takayasu’s arteritis (TA). Material and Methods: The study comprised ten pregnant women at the time of diagnosis or afterwards among the 50 patients diagnosed with TA between 2003 and 2021. Twenty-one pregnancy outcomes of 10 patients were obtained from hospital records and telephonic interviews. Two pregnancies were excluded due to timing before diagnosis. Results: Based on the angiographic classification, six patients had type 1, two had type 2b, and two had type 1+4 TA. 63.15% of pregnancies were planned, and the rheumatologist approved 42.10%. Live birth occurred in 16 (84.2%) of 19 pregnancies, three pregnancies (15.7%) resulted in abortion and two (10.5 %) of 19 pregnancies ended in neonatal death. In five (26.3%) of the 19 pregnancies, the disease was activated during pregnancy. Two neonatal deaths were from the two patients diagnosed with preeclampsia during pregnancy. Pre-existing hypertension and active disease are shared features of these two patients. After one year of follow-up, six pregnancies (31.5%) had active disease, and four (66.6%) had active disease both before and during pregnancy. While fetal data analysis revealed no congenital anomalies, four pregnancies resulted in low birth weight and intrauterine growth retardation (21.05%). Conclusions: The risk of developing preeclampsia and neonatal death should be considered, especially in TA patients with pre-existing hypertension who become pregnant during active disease.

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Obstetrical management of patients with extra‐anatomic vascular bypass grafts due to Takayasu arteritis

Cited by 5 publications

References 10 publications

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Clinical analysis: 13 cases of pregnancy complicated with Takayasu arteritis

Challenges in Family Planning and Pregnancy for Women with Rheumatic Diseases

Maternal and fetal outcomes in pregnant women with Takayasu’s arteritis: single center experience over ten years

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