Successful pregnancy in Takayasu's arteritis type III with complete infrarenal aortic block.
Priya SankarappanParvathi NaikHaritha SagiliPublished in: BMJ case reports (2024)
A Gravida 2 Para 1 Live 1 in her late 20s and of South Asian ethnicity with previous lower segment caesarean section (LSCS) was hospitalised for confinement at 37 weeks for chronic hypertension with superimposed pre-eclampsia.The patient was diagnosed with type III Takayasu's arteritis following a previous uncomplicated pregnancy. A year after her first childbirth, she presented with headache, recurrent scleritis, hypertension, bilateral absent lower limb pulses and right femoral bruit. CT angiogram revealed concentric thickening of the aorta and complete occlusion of the infrarenal aorta, with a saccular aneurysm 18 mm in diameter in the distal thoracic aorta at the T10 level. She was started on immunosuppressants and antihypertensives. During the current pregnancy, she received multidisciplinary care and underwent an elective LSCS with intrauterine contraceptive device (IUCD) placement at term under spinal anaesthesia. Postoperatively, nitroglycerine infusion followed by oral labetalol was administered for hypertension. She was discharged on day 10 with regular follow-up.
Keyphrases
- type iii
- aortic valve
- blood pressure
- pulmonary artery
- lower limb
- preterm birth
- coronary artery
- pregnancy outcomes
- abdominal aortic aneurysm
- spinal cord
- healthcare
- case report
- aortic dissection
- gestational age
- low dose
- quality improvement
- palliative care
- computed tomography
- patients undergoing
- minimally invasive
- single cell
- pregnant women
- magnetic resonance imaging
- pulmonary arterial hypertension
- heart failure
- left ventricular
- image quality
- contrast enhanced
- spinal cord injury
- positron emission tomography
- optic nerve
- atrial fibrillation
- optical coherence tomography