Most Read Articles
15 Sep 2018
Prenatal and postpartum vitamin D supplementation does not appear to improve foetal or infant growth, a study reports.
Tristan Manalac, 3 days ago
The causes, presentations and management of anaphylaxis vary considerably with age, according to a recent Singapore study, which reported that children are more likely to present with food anaphylaxis, while drug anaphylaxis is more common in adults.
Pearl Toh, 2 days ago
Low-density lipoprotein cholesterol (LDL-C) levels remained high in many patients with stable or acute coronary heart disease (CHD) in Asia, despite having a very high risk of recurrent cardiovascular (CV) events, indicating that the use of lipid-lowering therapies and lipid monitoring were inadequate.
13 Sep 2018
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.

Pregnant patients with active Takayasu arteritis at risk for CV events, maternal complications

Stephen Padilla
25 Jun 2018

Although majority of Takayasu arteritis (TA) pregnancies are uneventful and have favourable foetal and maternal outcomes, pregnant TA patients with active disease are at increased risk of developing maternal complications, particularly cardiovascular events, according to a study presented at the European League Against Rheumatism (EULAR) Congress 2018.

“In this setting, close monitoring and disease remission should be maintained during pregnancy,” researchers said.

Overall, nine patients had a total of 15 pregnancies, with nine (60 percent) occurring prior to TA diagnosis (group 1) and six (40 percent) occurring concomitant with or after TA diagnosis (group 2). [EULAR 2018, abstract AB0667]

The extent of arterial involvement in the first group was mostly consistent with type I TA (six pregnancies; 66.66 percent). There were no foetal or maternal complications seen in this group.

Patients in group 2 most commonly encountered type III TA (four pregnancies; 66.66 percent). Only one patient from the second group had >1 pregnancy following TA diagnosis. Two pregnancies (33.33 percent) in group 2 were reported to have active disease (National Institutes of Health [NIH] >1).

There were exclusive occurrences of cardiovascular events during two pregnancies (33.33 percent) with active disease. One patient experienced severe aortic regurgitation and gestational hypertension during pregnancy, while the other one suffered from worsening of pre-existing hypertension. Steroid dose increase and addition of antihypertensive medications were required in these cases.

No obstetric events were recorded in the second group.

In this retrospective study, 15 female patients fulfilling the American College of Rheumatology 1990 criteria for TA classification were included. Researchers gathered data regarding the number of pregnancies, disease characteristics and pregnancy-related events from medical records.

The Numano classification criteria for TA was used to categorize disease extent: type I (four patients; 26.66 percent), type IIa (one patient; 6.66 percent), type IIb (one patient; 6.66 percent), type III (four patients; 26.66 percent), type IV (two patients; 13.33 percent) and type V (three patients; 20 percent).

Researchers evaluated the prevalence of obstetric and maternal complications in women before or after TA diagnosis. Six patients were further excluded due to the scarcity of information concerning pregnancy outcomes.

“Fertility and pregnancy are concerning issues in women of childbearing age with TA. Available data on the management and expected events in TA during pregnancy are sparse and inconsistent among study populations,” researchers said. [Arthritis Care Res (Hoboken) 2017;69:1384-1390; J Rheumatol 2015;42:1861-1864]

“Conflicting reports exist on both favourable pregnancy outcomes as well as increased foetal or maternal complications,” they added. [J Obstet Gynaecol Res 2014;40:2031-2036; Arthritis Rheumatol 2015;67:3262-3269]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
15 Sep 2018
Prenatal and postpartum vitamin D supplementation does not appear to improve foetal or infant growth, a study reports.
Tristan Manalac, 3 days ago
The causes, presentations and management of anaphylaxis vary considerably with age, according to a recent Singapore study, which reported that children are more likely to present with food anaphylaxis, while drug anaphylaxis is more common in adults.
Pearl Toh, 2 days ago
Low-density lipoprotein cholesterol (LDL-C) levels remained high in many patients with stable or acute coronary heart disease (CHD) in Asia, despite having a very high risk of recurrent cardiovascular (CV) events, indicating that the use of lipid-lowering therapies and lipid monitoring were inadequate.
13 Sep 2018
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.