Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
BMJ Case Rep. 2024 Aug 21;17(8):e260062. doi: 10.1136/bcr-2024-260062.
A Gravida 2 Para 1 Live 1 in her late 20s and of South Asian ethnicity with previous lower segment caesarean section (LSCS) was hospitalised for confinement at 37 weeks for chronic hypertension with superimposed pre-eclampsia.The patient was diagnosed with type III Takayasu's arteritis following a previous uncomplicated pregnancy. A year after her first childbirth, she presented with headache, recurrent scleritis, hypertension, bilateral absent lower limb pulses and right femoral bruit. CT angiogram revealed concentric thickening of the aorta and complete occlusion of the infrarenal aorta, with a saccular aneurysm 18 mm in diameter in the distal thoracic aorta at the T10 level. She was started on immunosuppressants and antihypertensives. During the current pregnancy, she received multidisciplinary care and underwent an elective LSCS with intrauterine contraceptive device (IUCD) placement at term under spinal anaesthesia. Postoperatively, nitroglycerine infusion followed by oral labetalol was administered for hypertension. She was discharged on day 10 with regular follow-up.
一位 20 多岁的南亚裔经产妇，此前有过下段剖宫产术（LSCS）史，因慢性高血压伴子痫前期于孕 37 周住院分娩。该患者在第一次妊娠后被诊断为 III 型 Takayasu 动脉炎。第一次分娩一年后，她出现头痛、复发性巩膜炎、高血压、双侧下肢无脉搏和右股动脉杂音。CT 血管造影显示主动脉呈同心性增厚，肾下主动脉完全闭塞，在 T10 水平的胸主动脉远段有一个 18 毫米直径的囊状动脉瘤。她开始接受免疫抑制剂和降压药治疗。在本次妊娠期间，她接受了多学科治疗，并在孕晚期于脊髓麻醉下行选择性 LSCS 并放置宫内节育器（IUCD）。术后，给予硝酸甘油输注，然后口服拉贝洛尔治疗高血压。她在术后第 10 天出院，定期随访。
