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Management and evaluation of pregnant women with Takayasu arteritis

  • Atakan Tanacan
  • Canan Unal
  • Halise Meltem Yucesoy
  • Sinem Ayse Duru
  • Mehmet Sinan Beksac
Maternal-Fetal Medicine

Abstract

Purpose

To evaluate the clinical characteristics, obstetric/neonatal outcomes, and pregnancy complications of pregnant women with Takayasu arteritis (TA).

Methods

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.

Results

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.

Conclusion

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.

Keywords

Takayasu arteritis Pregnancy Obstetric outcomes Antenatal care program 

Notes

Acknowledgements

Oue special thanks are due to rheumatology, cardiology, and neonatology divisions for their efforts in providing the patients with optimal health care.

Author contributions

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.

Funding

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.

Ethical approval

The study protocol was approved by Hacettepe University Ethics Committee (GO 18/68).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Perinatology, Department of Obstetrics and Gynecology, Medical FacultyHacettepe UniversityAnkaraTurkey

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