Tanaka Hiroaki, Tanaka Kayo, Kamiya Chizuko, Iwanaga Naoko, Yoshimatsu Jun
Department of Perinatology, National Cerebral and Cardiovascular Center, Osaka, Japan.
J Obstet Gynaecol Res. 2014 Sep;40(9):2031-6. doi: 10.1111/jog.12443.
The incidence of Takayasu arteritis during child-bearing years is relatively high. The management of pregnancies in patients with this disease is of great importance in clinical obstetrics. Here we analyzed pregnancies of women with Takayasu arteritis with and without complications.
We retrospectively identified 27 pregnancies in 20 women with Takayasu arteritis seen between 1983 and 2005 at the National Cardiovascular Center, in Osaka, Japan. The incidences of obstetric events, steroid dose increase in pregnancy, and cardiovascular events were compared between group I (no complications), group II (one complication), and group III (two or more complications).
None of the pregnancies showed Takayasu arteritis activity. The obstetric events were pre-eclampsia in four pregnancies (15%), fetal growth restriction in one (4%), and abruption in one (4%). Three pregnancies involved a steroids dose increase. There were no cardiovascular events. Eighty percent of the pregnancies that included an obstetric event also involved the mother's chronic hypertension.
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.
高安动脉炎在育龄期的发病率相对较高。对于患有这种疾病的患者,孕期管理在临床产科中至关重要。在此,我们分析了患有和未患有并发症的高安动脉炎女性的妊娠情况。
我们回顾性地确定了1983年至2005年期间在日本大阪国立心血管中心就诊的20例患有高安动脉炎的女性的27次妊娠。比较了I组(无并发症)、II组(一种并发症)和III组(两种或更多并发症)的产科事件发生率、孕期类固醇剂量增加情况以及心血管事件发生率。
所有妊娠均未出现高安动脉炎活动。产科事件包括4次妊娠发生先兆子痫(15%)、1次妊娠发生胎儿生长受限(4%)和1次妊娠发生胎盘早剥(4%)。3次妊娠涉及类固醇剂量增加。未发生心血管事件。发生产科事件的妊娠中,80%的孕妇同时患有慢性高血压。
无高安动脉炎活动的孕妇发生心血管事件的风险较低。对于患有慢性高血压的女性,应注意先兆子痫、胎儿生长受限和胎盘早剥的发生。