Alpay-Kanitez N, Omma A, Erer B, Artim-Esen B, Gül A, Inanç M, Öcal L, Kamali S
Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.
Clin Exp Rheumatol. 2015 Mar-Apr;33(2 Suppl 89):S-7-10. Epub 2014 Sep 19.
Takayasu arteritis is a chronic large-vessel vasculitis in young women of reproductive age. We aimed to obtain information on pregnancy in TA retrospectively.
Takayasu arteritis patients with history of pregnancy were included in this study. The evaluations included physical findings, serum C-reactive protein, erythrocyte sedimentation rate as well as history and symptoms. Information about pregnancies, abortus, deliveries and newborns was obtained from medical records. Disease activity score, disease damage index appraised Kerr's criteria and vasculitis damage index (VDI) and medication were recorded.
Thirty-six Takayasu arteritis patients who had a total of 84 pregnancies were evaluated. The mean age of patients ranged 24.5 ± 6.6 years. Subclavian arteries (86%) were the most frequently involved vessels. We were able to complete the follow-up of ten patients who had a pregnancy after diagnosis during the period of pregnancy. Two patients who had renal artery involvement and active disease in third trimester suffered from preeclampsia and a worsening of hypertension. In one of them, disease flared up in the third trimester. There was no active disease in the postpartum sixth month. Maternal heart failure, cerebrovascular accident, death or cerebral hypoperfusion at the time of delivery, asphyxia and newborn anomalies were not seen in any of these patients.
TA pregnancies may have a favourable outcome with regular follow-up schedule and close monitorisation of blood pressure.
大动脉炎是一种发生于育龄期年轻女性的慢性大血管血管炎。我们旨在回顾性获取大动脉炎患者妊娠方面的信息。
本研究纳入有妊娠史的大动脉炎患者。评估内容包括体格检查结果、血清C反应蛋白、红细胞沉降率以及病史和症状。从病历中获取有关妊娠、流产、分娩和新生儿的信息。记录疾病活动评分、根据克尔标准评估的疾病损伤指数和血管炎损伤指数(VDI)以及用药情况。
对36例大动脉炎患者共84次妊娠进行了评估。患者的平均年龄为24.5±6.6岁。锁骨下动脉(86%)是最常受累的血管。我们能够对10例诊断后妊娠的患者在孕期进行随访。2例在孕晚期有肾动脉受累且疾病活动的患者发生了先兆子痫和高血压加重。其中1例在孕晚期病情复发。产后第六个月无疾病活动。这些患者中均未出现分娩时的母体心力衰竭、脑血管意外、死亡或脑灌注不足、窒息和新生儿异常。
通过定期随访和密切监测血压,大动脉炎患者的妊娠可能会有良好结局。