title: Takayasu arteritis in pregnancy: an analysis from eastern India.
abstract: OBJECTIVE
  Takayasu's Arteritis (TA) is a rare inflammatory disease of medium and large size arteries that affects women of reproductive age. This study aims to highlight the antenatal management and analyze the obstetric outcome in women with TA.
  
  
  METHODS
  This retrospective study was carried out in the Department of O&G, Cardiology and Rheumatology--IPGME&R, Kolkata from June 2002 to July 2010. Sixteen patients with 29 pregnancy events were compared with 60 matched controls.
  
  
  RESULTS
  Clinical presentation of study population at admission included unequal or absent pulse, hypertension, congestive cardiac failure, retinopathy, aortic regurgitation and cerebrovascular accident (CVA). Mode of delivery was cesarean in 20 pregnancies (71.49%) and vaginal in nine pregnancies (31.03%). Significant maternal complications included pregnancy induced hypertension (100 vs. 1.66%; P < 0.001), preeclampsia (92.85 vs. 0%; P < 0.001), postpartum hemorrhage (17.24 vs. 1.66%; P < 0.001) and preterm labor (17.24 vs. 3.33%; P < 0.001). One maternal mortality was present due to CVA. Neonatal outcome showed 26 live births with increased incidence of intrauterine growth restriction (51.72 vs. 1.66%; P < 0.001) and neonates requiring NICU admissions (58.62 vs. 5.0%; P < 0.001).
  
  
  CONCLUSIONS
  Although conception was spontaneous in all these pregnancies, antenatal and intrapartum control of blood pressure played a pivotal role in pregnancy outcome. High rate of operative interference was present. All subsequent pregnancies had similar outcome due to slow progression of the disease. Although pregnancy was complicated by hypertension and its sequelae, successful outcome could be achieved with timely admission, judicious medication and multidisciplinary approach.
authors.affiliation: Department of Obstetrics and Gynecology, IPGME&R, SSKM Hospital, 244 AJC Bose road, Kolkata 700020, West Bengal, India. drdebasmitamondal@yahoo.com
authors.forename: Debasmita
authors.initials: D
authors.lastname: Mandal
authors.forename: Saroj
authors.initials: S
authors.lastname: Mandal
authors.forename: Chaitali
authors.initials: C
authors.lastname: Dattaray
authors.forename: Dipanwita
authors.initials: D
authors.lastname: Banerjee
authors.forename: Parasar
authors.initials: P
authors.lastname: Ghosh
authors.forename: Alokendu
authors.initials: A
authors.lastname: Ghosh
authors.forename: Manotosh
authors.initials: M
authors.lastname: Panja
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology*; D007194:India; D007231:Infant, Newborn; D008428:Maternal Mortality; D007752:Obstetric Labor, Premature / Q000209:etiology*; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000150:complications*; D055815:Young Adult