Clinical manifestations of pregnancy in patients with Takayasu arteritis: Experience from a single tertiary center

Objectives Takayasu arteritis predominantly affects young women of reproductive age; therefore, the management of pregnancies with this disease is of great importance in clinical obstetrics. However, only a limited number of such cases have been reported in the English literature. Our aim in this study was to investigate the clinical features of pregnant women with Takayasu arteritis managed at a tertiary center in Japan. Methods We conducted a retrospective study of 26 pregnancies (18 deliveries) in 10 women with Takayasu arteritis, who were managed at Kyushu University Hospital between 1996 and 2010. Data were collected retrospectively by reviewing the maternal medical records. Results The mean age of these patients at delivery was 29.3 ± 5.2 years. Six patients had lesions above and below the diaphragm, and four patients showed isolated supra-diaphragmatic disease. Echocardiography was performed in all patients, and aortic regurgitation was observed in six. Five pregnancies resulted in spontaneous abortion, and three pregnancies were legally terminated at the patients' request. The remaining 18 pregnancies resulted in live births. Of the 18 live babies born, growth restriction was observed in 2 babies. Superimposed pregnancy-induced hypertension was observed in two cases, and other severe complications, such as cerebral hemorrhage or cardiac failure did not occur. Conclusion Although Takayasu arteritis is a potentially severe condition during pregnancy, successful pregnancy is possible if extreme caution is followed. Blood pressure should be strictly controlled and the delivery should be planned for favorable maternal and fetal outcomes.