A successful pregnancy in a patient with Takayasu's arteritis

Takayasu's arteritis is a chronic, idiopathic, inflammatory disease of the arteries, which primarily involves the aorta, its main branches such as the brachiocephalic, carotid, subclavian, vertebral, and renal arteries, as well as the coronary and pulmonary arteries. It has been suggested that pregnancy, although not usually associated with an exacerbation of inflammatory vascular lesions, should only be considered during a phase of remission. The increased intravascular volume seen during pregnancy may impair circulation and exacerbate aortic regurgitation, hypertension, and congestive heart failure. Hypertension is probably the most serious major complication that can develop, possibly leading to intrauterine growth retardation, maternal heart failure, and fetal haemorrhage. We describe the case of a patient with a 7-year history of Takayasu's arteritis who conceived against medical advice. She continued to take her prescribed medication throughout the pregnancy, including adalimumab, leflunomide (until 8 weeks' gestation), and prednisolone. She underwent a planned cesarean section under spinal anesthesia at 37 + 2 weeks' gestation, and a healthy baby boy weighing 2550 g was delivered. There were no postpartum complications.