Open Journal of Obstetrics and Gynecology, 2019, 9, 1151-1160
http://www.scirp.org/journal/ojog
ISSN Online: 2160-8806
ISSN Print: 2160-8792
DOI: 10.4236/ojog.2019.98111 Aug. 15, 2019 1151 Open Journal of Obstetrics and Gynecology
Successful Management of Takayasu’s Arteritis
with Pulmonary Hypertension in Pregnancy: A
Rare Case
Wiryawan Permadi, Dani Setiawan, Muhammad Alamsyah Aziz
*
, Yanuarman, Anita D. Anwar,
Firman Fuad Wirakusumah
Obstetrics and Gynecology Department, Faculty of Medicine, Padjadjaran University, Hasan Sadikin Hospital,
Bandung, Indonesia
Abstract
Introduction: Takayasu’s arteritis (TA) is a rare systemic, chronic inflam-
matory, progressive, idiopathic disease of aorta and its main branches. Ta-
kayasu’s arteritis causes narrowing, occlusion and aneurysm of arteries. The
etiology of TA is still unknown. It may be autoimmune or genetic in origin or
infective diseases. It is commonly found in Asia and oriental countries.
Worldwide annual incidence is 1.2 - 2.6 cases/million. Women are affected in
80% - 90% of cases with age of onset below 40 years. TA does not worsen or
improve with pregnancy but has adverse effect on pregnancy in the form of
abortion, Intrauterine fetal death, superimposed preeclampsia, Intrauterine
growth restriction, abruption and congestive heart failure. Because the disease
is common in women of childbearing age, management of pregnancy in these
patients becomes important; however optimal management for pregnant pa-
tients with this disease has not yet been established. Due to the manifold car-
diovascular complications that can occur in the course of the disease, man-
agement of pregnancies in TA patients is a challenge for the clinician. An in-
terdisciplinary collaboration of obstetrician, rheumatologist, cardiologist and
anaesthetist is necessary to improve maternal and fetal prognosis. This was
the first reported case of TA in pregnancy in Hasan Sadikin Hospital with
superimposed preeclampsia and pulmonary hypertension. Materials and
Methods: The patient, G1P0A0 was diagnosed as TA since one year ago, and
when the patient was pregnant, the patient routinely came to obstetric and
rheumatology clinics. Angiographic examination showed dilatation of aorta
ascendant, narrowing of aorta descendent at 8 thoracal vertebrae, and arcus
aorta, abdominal aorta and the branches were without abnormalities that lead
to type IIb TA. On physical examination blood pressure was 200/100 mmHg
How to cite this paper: Permadi, W.,
Setiawan, D., Alamsyah Aziz, M., Yanuar-
man, Anwar, A.D. and Wirakusumah, F.F.
(2019) Successful Management of Takaya-
su’s Arteritis with Pulmonary Hypertension
in Pregnancy: A Rare Case. Open Journal of
Obstetrics and Gynecology, 9, 1151-1160.
https://doi.org/10.4236/ojog.2019.98111
Received: June 3, 2019
Accepted: August 12, 2019
Published: August 15, 2019
Copyright © 2019 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access