TY - JOUR
T1 - Pregnancy outcome in patients with Takayasu’s arteritis
T2 - cohort study and review of the literature
AU - Kirshenbaum, Michal
AU - Simchen, Michal J.
N1 - Publisher Copyright:
© 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2018/11/2
Y1 - 2018/11/2
N2 - Objective: The objective of this study is to investigate the clinical features of pregnancy in women with Takayasu’s arteritis managed in a tertiary medical center and review the literature in order to establish the course and recommended follow up and treatment for these pregnancies. Materials and methods: Retrospective analysis of 20 pregnancies in 6 women with Takayasu’s arteritis. Patients were recruited from the high risk pregnancy clinics at Sheba Medical Center, where follow up included strict control of blood pressure and treatment of obstetric and disease-related complications. Results: Mean maternal age was 29.3 ± 3 years. Thirty-six patients had both supra and infradiaphragmatic arterial disease, of them two had an abdominal aorta involvement and three out of six patients had an isolated supradiaphragmatic disease. Of 20 pregnancies, six pregnancies (30%) resulted in early spontaneous miscarriages, and one pregnancy was terminated at 17 weeks due to fetal anomalies. The remaining 13 pregnancies (65%) resulted in live births. Three out of 13 (23%) neonates were small-for-gestational-age. The most common complication was maternal hypertension affecting 8/13 (61.5%) pregnancies. Preeclampsia occurred in one pregnancy. Four out of 13 (30.7%) pregnancies necessitated preterm induction of labor due to obstetric indications or uncontrolled disease. Conclusions: Although Takayasu’s arteritis is associated with pregnancy complications, tight preconception disease control, strict follow up, and targeted treatment of high blood pressure can result in positive pregnancy outcome.
AB - Objective: The objective of this study is to investigate the clinical features of pregnancy in women with Takayasu’s arteritis managed in a tertiary medical center and review the literature in order to establish the course and recommended follow up and treatment for these pregnancies. Materials and methods: Retrospective analysis of 20 pregnancies in 6 women with Takayasu’s arteritis. Patients were recruited from the high risk pregnancy clinics at Sheba Medical Center, where follow up included strict control of blood pressure and treatment of obstetric and disease-related complications. Results: Mean maternal age was 29.3 ± 3 years. Thirty-six patients had both supra and infradiaphragmatic arterial disease, of them two had an abdominal aorta involvement and three out of six patients had an isolated supradiaphragmatic disease. Of 20 pregnancies, six pregnancies (30%) resulted in early spontaneous miscarriages, and one pregnancy was terminated at 17 weeks due to fetal anomalies. The remaining 13 pregnancies (65%) resulted in live births. Three out of 13 (23%) neonates were small-for-gestational-age. The most common complication was maternal hypertension affecting 8/13 (61.5%) pregnancies. Preeclampsia occurred in one pregnancy. Four out of 13 (30.7%) pregnancies necessitated preterm induction of labor due to obstetric indications or uncontrolled disease. Conclusions: Although Takayasu’s arteritis is associated with pregnancy complications, tight preconception disease control, strict follow up, and targeted treatment of high blood pressure can result in positive pregnancy outcome.
KW - Antenatal management
KW - Takayasu arteritis
KW - hypertension
KW - pregnancy outcome
UR - http://www.scopus.com/inward/record.url?scp=85026873124&partnerID=8YFLogxK
U2 - 10.1080/14767058.2017.1359529
DO - 10.1080/14767058.2017.1359529
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C2 - 28738750
AN - SCOPUS:85026873124
SN - 1476-7058
VL - 31
SP - 2877
EP - 2883
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 21
ER -