Takayasu arteritis, pregnancy and delivery: Case report

Abstract

© 2018, Kuwait Medical Association. All rights reserved. Takayasu arteritis (TA) is a rare chronic inflammatory disease affecting major arterial vessels, the aorta and its branches, as well as peripheral blood vessels. Due to numerous cardiovascular complications, the best management for pregnant patients with TA is controversial and challenging for the anesthesiolgist and obstetrician. In this case report, we describe a 24-year-old primigravida diagnosed with TA. The patient was admitted to our hospital at 29 weeks of pregnancy complaining of breathlessness, dyspnea, palpitations and fatigue. Upon physical examination, and following electrocardiogram (EKG), chest X-ray and cardiac ultrasound analyses, the patient was diagnosed with heart failure with preserved left-ventricular ejection fraction (HF-PEF). After a two-week treatment, due to a high risk of cardiac and pulmonary complications, we performed a cesarean section (CS) under general anesthesia (GA). Patient evaluation, determining the optimal time and mode of delivery and anesthetic planning are essential to ensure a successful outcome in pregnant patients with Takayasu arteritis.