David Liji Sarah, Beck Manisha Madhai, Kumar Manish, Rajan Sudha Jasmine, Danda Debashish, Vijayaselvi Reeta
Clinic of Obstetrics and Gynaecology, Christian Medical College and Hospital, Vellore, India
Clinic of Neonatology, Christian Medical College and Hospital, Vellore, India
J Turk Ger Gynecol Assoc. 2020 Mar 6;21(1):15-23. doi: 10.4274/jtgga.galenos.2019.2019.0115. Epub 2019 Sep 30.
To study obstetric and perinatal outcomes among pregnant women with Takayasu arteritis (TA), attending our hospital for pregnancy and childbirth between January 2011 to December 2016.
Retrospective study was carried out by abstracting clinical charts on all pregnant women with TA who underwent antenatal care and/or delivery in our hospital during this period. American College of Rheumatology criteria was used for diagnosis of TA. Sixteen women with TA were included in the study. Maternal demographic data, stage of disease, complications related to disease, details of treatment taken prior to pregnancy, pregnancy outcomes, and neonatal outcomes were studied.
Forty-four percentage (7/16) belonged to type 5 angiographic type, however the same proportion (7/16) had undergone surgical corrections prior to pregnancy and the majority (15/16) were on medical management. Only three women (19%) were diagnosed during pregnancy. Most did not have active disease measured by Kerr’s criteria (n=12; 75%), and Indıan Takayasu clinical activity scores A. Chronic hypertension was the commonest antenatal complication (56.2%), nearly one-third had growth restricted babies and 25% had preterm labour. There were no cardiovascular events, no maternal deaths, nor fetal or neonatal deaths. Two-thirds of our women were delivered by caesarean section.
Preconceptional counselling is of paramount importance in women with TA. Good maternal and fetal outcomes are observed with close antenatal surveillance and multidisciplinary care. Pregnancy should be planned during disease remission, with good antenatal care, close monitoring of clinical symptoms, early diagnosis and treatment of complications.
研究2011年1月至2016年12月期间在我院妊娠和分娩的高安动脉炎(TA)孕妇的产科和围产期结局。
通过提取在此期间在我院接受产前护理和/或分娩的所有TA孕妇的临床病历进行回顾性研究。采用美国风湿病学会标准诊断TA。16例TA女性纳入研究。研究产妇的人口统计学数据、疾病阶段、与疾病相关的并发症、妊娠前接受的治疗细节、妊娠结局和新生儿结局。
44%(7/16)属于5型血管造影类型,然而相同比例(7/16)在妊娠前接受了手术矫正,大多数(15/16)接受药物治疗。仅3名女性(19%)在孕期被诊断。根据克尔标准,大多数患者无活动期疾病(n = 12;75%),以及印度高安临床活动评分A。慢性高血压是最常见的产前并发症(56.2%),近三分之一的胎儿生长受限,25%早产。无心血管事件、孕产妇死亡、胎儿或新生儿死亡。三分之二的女性通过剖宫产分娩。
对于TA女性,孕前咨询至关重要。通过密切的产前监测和多学科护理可观察到良好的母婴结局。应在疾病缓解期计划妊娠,提供良好的产前护理,密切监测临床症状,早期诊断和治疗并发症。