Challenges of Takayasu Arteritis in Pregnancy: A Case Report

2017 ◽  
Vol 51 (4) ◽  
pp. 195-198 ◽  
Author(s):  
Sarah Soo-Hoo ◽  
Jenny Seong ◽  
Brandon R. Porten ◽  
Nedaa Skeik
Keyword(s):  
Heart Failure ◽  
Takayasu Arteritis ◽  
Cardiovascular Complications ◽  
Unknown Etiology ◽  
Optimal Management ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Clinical Challenge ◽  
Increased Risk ◽  
In Pregnancy

Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. Furthermore, optimal management has not yet been established for pregnant patients with Takayasu arteritis, posing a clinical challenge. We present a case of a young woman with Takayasu arteritis whose symptoms and disease activity improved during 2 pregnancies. Although her first pregnancy was complicated with preeclampsia, gestational diabetes, and preterm vaginal delivery, her second pregnancy was uneventful. This case provides a rare glimpse of Takayasu arteritis in pregnancy and highlights the challenges of medical management in gravid patients.

scholarly journals Challenges with Takayasu arteritis in pregnancy: a case report

2021 ◽  
Vol 10 (5) ◽  
pp. 2115
Author(s):  
Monika Dalal ◽  
Vani Malhotra ◽  
Smiti Nanda ◽  
Meenakshi Chauhan ◽  
Vandana Rani ◽  
...  
Keyword(s):  
Takayasu Arteritis ◽  
Interdisciplinary Collaboration ◽  
Pulmonary Arteries ◽  
Good Control ◽  
Cardiovascular Complications ◽  
Unknown Etiology ◽  
Chronic Hypertension ◽  
Increased Risk ◽  
Life Threatening ◽  
Female Baby

Takayasu’s arteritis (TA) is a rare, chronic, inflammatory, large vessel vasculitis (LVV) of unknown etiology characterized by narrowing, occlusion, and aneurysms of systemic and pulmonary arteries affecting especially the aorta and its branches. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes, so one should pay special attention to these patients. We present a case of 30-year-old female G5P3L2A1 with 9 months of amenorrhea with previous 2 LSCS with chronic hypertension and superimposed pre-eclampsia with oligohydraminos. She was a known case of Takayasu arteritis, diagnosed since she was 16 years old. Her lower limb pulses were palpable with absent upper limb pulses. On Echocardiography there was dilated aortic root, moderate MR and LVEF was 55%. She proceeded to have emergency LSCS under spinal anesthesia in view of severe pre-eclampsia with previous 2 LSCS at 35 week and delivered alive healthy female baby weight 2.1 kg. A life-threatening maternal cardiovascular complication is observed in more than 5% of pregnant women with TA. Hypertension is present in 90% cases of Takayasu arteritis. A good control of TA disease activity and arterial hypertension before conception and during pregnancy is important to improve feto-maternal outcomes. Pregnancies in the setting of TA should be considered high-risk, requiring a close interdisciplinary collaboration of rheumatologists, nephrologists and obstetrician’s specialists involved in care of TA.

scholarly journals Takayasu arteritis: a comprehensive review of literature

2020 ◽  
Vol 8 (9) ◽  
pp. 3418
Author(s):  
Ravin K. Bishnoi ◽  
Shivani Devi ◽  
Shivani Rai ◽  
Gunjot .
Keyword(s):  
Takayasu Arteritis ◽  
Standard Test ◽  
Unknown Etiology ◽  
Asian Women ◽  
Review Of Literature ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Gold Standard Test ◽  
Three Stages ◽  
Stenotic Lesions

Takayasu arteritis is an inflammatory pulseless disease of large arteries with unknown etiology which advances in three stages i.e. early systemic, vascular, and burnout stage. It is more prevalent in Asian women of childbearing age. Hypertension, fever, weight loss, arthralgia, limb claudication, light-headedness, and arterial pain are common manifestations. Angiography is a gold standard test to evaluate TA. There is no reliable serological marker has been identified. Control on the inflammatory process and hypertension are two imperative angles to treat the disease. Steroids are most used. Reconstructive surgeries are limited to severe and stenotic lesions. This review aims to report comprehensive evidence about Takayasu arteritis. We conducted an integrative review of theoretical and empirical publications reporting epidemiology, etiopathogenesis, classification, diagnostic evaluation, and management of TA. The authors searched PubMed, Embase, and Scopus until March 2020.  A total of 1104 records found, we included 37 papers for review after reading the articles. Remaining was excluded because of no innovative content, insufficient details, and no clear endpoints. This review of the literature presents comprehensive evidence in all fields of TA. Still, large areas need to be studied for better management of patients with TA.

Cardiovascular complications of novel multiple myeloma treatments

ESC CardioMed ◽  
2018 ◽  
pp. 1176-1178
Author(s):  
Daniel J. Lenihan
Keyword(s):  
Heart Failure ◽  
Multiple Myeloma ◽  
Heart Disease ◽  
Early Detection ◽  
Antithrombotic Therapy ◽  
Cardiovascular Events ◽  
Cardiovascular Complications ◽  
Novel Therapies ◽  
Cardiac Events ◽  
Increased Risk

The treatment of multiple myeloma has dramatically changed in the last decade. Novel therapies have had an important impact on the overall outcome for patients but are associated with important cardiovascular events. There is certainly concern about the development of heart failure but also treatment-induced hypertension and a known increased risk of thrombotic events, including ischaemic heart disease. The management of these cardiac events includes prevention, early detection, and optimal treatment with antithrombotic therapy as well as medical therapy for heart failure.

Diabetes in pregnancy: a practical guide for midwives

2019 ◽  
Vol 27 (7) ◽  
pp. 413-419
Author(s):  
Aarthi Surendran ◽  
Danielle Dixon ◽  
Martin Whyte
Keyword(s):  
Gestational Diabetes ◽  
Diabetes Management ◽  
Antenatal Clinic ◽  
Women Of Childbearing Age ◽  
Diabetes In Pregnancy ◽  
Childbearing Age ◽  
Pregnancy And Childbirth ◽  
Rising Incidence ◽  
Concise Guide ◽  
In Pregnancy

Diabetes is a growing concern. With the rising incidence of obesity in the younger people, the incidence of diabetes has also increased. This has resulted in more women of childbearing age attending antenatal clinic with a diagnosis of either pre-existing or gestational diabetes. Management of these women is vital to avoid complications in both the mother and the child during pregnancy and childbirth. This article aims to provide a concise guide to the management of diabetes in pregnancy for midwives, who are often the first point of contact for these women.

scholarly journals Article Commentary: Acute Heart Failure: Is it Peripartum Cardiomyopathy or Not?

2013 ◽  
Vol 6 (1) ◽  
pp. 42-44
Author(s):  
Katrin Bachelier-Walenta ◽  
Denise Hilfiker-Kleiner ◽  
Karen Sliwa
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Peripartum Cardiomyopathy ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Life Threatening

Peripartum cardiomyopathy (PPCM) is a potentially life-threatening disease that occurs in women of childbearing age.

Veno-venous ECMO as a safe bridge to recovery in a patient with severe peripartum cardiomyopathy – learning from errors

Perfusion ◽  
2016 ◽  
Vol 32 (4) ◽  
pp. 328-332 ◽  
Author(s):  
Christopher Ull ◽  
Thomas Armin Schildhauer ◽  
Justus T. Strauch ◽  
Andreas Mügge ◽  
Justyna Swol
Keyword(s):  
Heart Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Peripartum Cardiomyopathy ◽  
Unknown Etiology ◽  
Multiparous Woman ◽  
Bridge To Recovery ◽  
Learning From Errors ◽  
Few Data ◽  
European Society Of Cardiology ◽  
In Pregnancy

Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child.

Fifteen-minute consultation: What do I do with a baby born to a mother with tuberculosis?

2020 ◽  
pp. edpract-2020-320002
Author(s):  
Lynne Speirs ◽  
Elizabeth Whittaker
Keyword(s):  
Infectious Diseases ◽  
Disease Burden ◽  
Optimal Management ◽  
Women Of Childbearing Age ◽  
Limited Evidence ◽  
Childbearing Age ◽  
Expectant Mother ◽  
Good Communication ◽  
The Uk ◽  
Paediatric Tuberculosis

Tuberculosis (TB) remains a considerable disease burden, even in high-income countries such as the UK. In recent years, there has been a change in epidemiology with an increased incidence in those under 30 years old. This increases the proportion of women of childbearing age contracting tuberculosis. There is limited evidence around optimal management of the neonate who has been exposed to tuberculosis; however, we know that neonatal TB is fatal if untreated. It is therefore important to have a framework of how to manage the infants born to these mothers. Good communication between respiratory or infectious diseases physicians treating the expectant mother, maternity and paediatric teams is essential. Prompt assessment of the infant with input from paediatricians with an expertise in paediatric tuberculosis is essential.

scholarly journals Women’s Health: Contemporary Management of MS in Pregnancy and Post-Partum

Biomedicines ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 32 ◽  
Author(s):  
Kelly Tisovic ◽  
Lilyana Amezcua
Keyword(s):  
Multiple Sclerosis ◽  
Post Partum ◽  
Fetal Exposure ◽  
Childbearing Age ◽  
Maternal Complications ◽  
Increased Risk ◽  
Effective Contraception ◽  
Disease Modifying ◽  
Contemporary Management ◽  
In Pregnancy

Multiple sclerosis (MS) primarily affects women in childbearing age and is associated with an increased risk of adverse post-partum outcomes. Relapses and now fetal exposure to disease modifying treatments in the early phase of pregnancy and thereafter are of concern. Safe and effective contraception is required for women who wish to delay or avoid pregnancy while on disease-modifying treatments. Counseling and planning is essential to assess the risk of both fetal and maternal complications, particularly now in the era of highly efficient and riskier therapies. The purpose of this review is to provide a practical framework using the available data surrounding pregnancy in MS with the goal of optimizing outcomes during this phase in MS.

CEREBROVASCULAR DISEASE AND PREGNANCY

2010 ◽  
Vol 21 (2) ◽  
pp. 114-162 ◽  
Author(s):  
MAYA KATZ ◽  
JENNIFER LESKO ◽  
KATHRYN F KIRCHOFF-TORRES ◽  
VICTOR ZACH ◽  
STEVEN R LEVINE
Keyword(s):  
Cerebrovascular Disease ◽  
District Of Columbia ◽  
Death Certificates ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Causes Of Mortality ◽  
In Pregnancy

Approximately 12%–27% of cerebrovascular disease in women of childbearing age is associated with pregnancy. The reported incidence of stroke in pregnancy ranges from 0.01%–0.05%. While these events are uncommon, they are often clinically devastating. The Center for Disease Control's (CDC) review of death certificates in all 50 states and the District of Columbia found that neurologic or neurovascular problems are one of the leading causes of mortality in pregnancy.

scholarly journals Socioeconomic status and vitamin D deficiency among women of childbearing age: a population-based, case–control study in rural northern China

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042227
Author(s):  
Shiqi Lin ◽  
Lifang Jiang ◽  
Yuan Zhang ◽  
Jian Chai ◽  
Jiajia Li ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Northern China ◽  
Population Based ◽  
Vitamin D Insufficiency ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Severe Deficiency ◽  
Increased Risk ◽  
Control Study

ObjectiveTo explore the association between socioeconomic status (SES) and vitamin D deficiency/insufficiency of women of childbearing age in rural northern China.DesignA population-based, case–control study was conducted.SettingFour counties of Henan Province, China from 2009 to 2010.Participants1151 non-pregnant healthy women between 18 and 40 years old.Primary and secondary outcome measuresSerum 25-hydroxyvitamin D (25(OH)D) levels were measured using high-performance liquid chromatography-tandem mass spectrometry. Vitamin D insufficiency was defined as serum 25(OH)D ≥20 ng/mL and <30 ng/mL, deficiency as ≥10 ng/mL and <20 ng/mL, and severe deficiency as <10 ng/mL. SES was measured separately by women’s and their husbands’ education level and occupation, household income and expenditure, as well as aggregately by SES index constructed with principal component analysis.ResultsThe median serum 25(OH)D level was 20.90 (13.60–34.60) ng/mL, and the prevalence of vitamin D insufficiency, deficiency and severe deficiency was 20.16%, 31.80% and 15.99%, respectively. After adjustment, household annual income <¥10 000 was associated with increased risk of vitamin D insufficiency (adjusted OR (aOR): 2.10, 95% CI 1.41 to 3.14), deficiency (aOR: 1.58, 95% CI 1.09 to 2.29) and severe deficiency (aOR: 2.79, 95% CI 1.78 to 4.38); inadequate household income for expenditure was associated with elevated risk of vitamin D insufficiency (aOR: 1.66, 95% CI 1.08 to 2.54) and deficiency (aOR: 1.81, 95% CI 1.26 to 2.62); low SES index was associated with elevated risk of vitamin D insufficiency (aOR: 2.40, 95% CI 1.52 to 3.80) and deficiency (aOR: 1.64, 95% CI 1.08 to 2.50); and both middle and low SES index were associated with increased risk of vitamin D severe deficiency (aOR: 1.70, 95% CI 1.02 to 2.84; aOR: 2.45, 95% CI 1.45 to 4.14).ConclusionsLower SES was associated with higher risk of vitamin D deficiency/insufficiency in women of childbearing age in rural northern China. More should be done to explore potential mechanisms and to narrow down SES inequalities in vitamin D status.

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