Pregnancy and Takayasu arteritis: a single centre experience from North India

Takayasu's syndrome is a chronic inflammatory arteriopathy of unknown origin which primarily affects women of reproductive age. We report the course and outcome of 37 pregnancies in 15 women with Takayasu arteritis during the period 1999-2008.

A retrospective analysis of 9 years was carried out in a tertiary hospital in Northern India. The effect of disease on the course of pregnancy, complications during pregnancy and perinatal outcome were analyzed.

Hypertension was the most common presenting feature (27%). In the majority of the patients, vessels involved were the subclavian artery and arch of the aorta. Superimposed preeclampsia complicated 62% of pregnancies while 16% of pregnancies had intrauterine growth retardation. Six patients had preterm delivery and one had preeclampsia and placental abruption. The mean gestational age at delivery was 36 +/- 3 weeks. The majority of the patients had a vaginal delivery. There was one maternal death due to accelerated hypertension and its complications.

Adequate control of blood pressure during pregnancy, planning the timing and mode of the delivery and vigilant monitoring during intrapartum period with special reference to management of blood pressure and its complications is essential for an optimum outcome.