Takayasu arteritis in pregnancy: an analysis from eastern India

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.     

Crohn disease in pregnancy. Considerations on and discussion of a clinical case]

Crohn's disease with acute abdomen in pregnancy is described. The Authors evaluate Crohn's disease together with the diagnostic, prognostic and therapeutic problems and relationships between this disease and pregnancy. They conclude as underlining the rarity of Crohn's disease beginning in pregnancy and so the importance of symptoms related to this disease in fertile age woman to make diagnosis and therapy before pregnancy.     

Takayasu arteritis in pregnancy: safe management options in antenatal care. Case report

Takayasu arteritis is a nonspecific chronic inflammatory vascular disease of unknown etiology with a higher incidence during the child-bearing years. It usually involves the branches of the aortic arch. Most of the patients enter the pregnancy being already diagnosed as having the disease and being on medication. The state of the disease in early pregnancy is a definitive factor for determining its management. Although it seems that pregnancy is a state favorable to this disease, nevertheless, complications should be anticipated, and close multidisciplinary maternal and fetal surveillance is mandatory. Early-onset hypertension is the commonest complication, and its magnitude during the late gestational period is the second definitive factor for the management of these pregnancies. A vaginal delivery should be aimed at term with continuous electronic fetal monitoring. The immediate postpartum period is usually uncomplicated despite the circulatory alterations that take place.     

Clinical manifestations of pregnancy in patients with Takayasu arteritis: experience from a single tertiary center

Objectives  

Takayasu arteritis predominantly affects young women of reproductive age; therefore, the management of pregnancies with this disease is of great importance in clinical obstetrics. However, only a limited number of such cases have been reported in the English literature. Our aim in this study was to investigate the clinical features of pregnant women with Takayasu arteritis managed at a tertiary center in Japan.     

Von Recklinghausen's disease and pregnancy]

On the basis of six cases and a review of the literature, the authors identify the special features associated with the combination of von Recklinghausen's disease and pregnancy. Fertility is unaffected and pregnancy possible. Careful monitoring is required because of severe complications. In certain probably minor forms of the disease, the outcome of pregnancy is favourable with no complications.     

Takayasu's arteritis and pregnancy: a case of deleterious association

The association of pregnancy with Takayasu's arteritis is almost always uneventful. A case with high values of maternal blood pressure (BP) and severe intra-uterine growth retardation (IUGR), submitted to aggressive management with the delivery of a live fetus at 30 weeks, is presented.     

Drug abuse, pregnancy and HIV infection]

It is estimated that there are between 50,000 and 90,000 drug abusers in the former West Germany. IV drug users are the second largest group of AIDS victims after homosexual and bisexual men. From 1989 to 1990, IV drug users up 16.1% of 1425 reported AIDS cases. 52% of 124 female AIDS cases were drug abusers. 4-12 weeks pass from the time of HIV infections to the appearance of HIV antibodies, thus testing is not foolproof. Heroin abuse often leads to oligo- or amenorrhea. yet 593 female IV drug users in New York City had 2289 pregnancies (often detecting their pregnancy too late for abortion), averaging 2.5 live births and 1.3 abortions. Fetal HIV transmission occurs in 20-40% of cases. The effectiveness of azidothymidine (AZT) prophylaxis is not clear. Only 29% of 50 HIV-infected women had complication-free pregnancies: 34% had premature pain and contractions, and 11 of 49 children were born prematurely before the 35th week. Drugs used include opiates, barbiturates, cocaine, cannabis, amphetamine, LSD, and mescaline. The daily cost of addiction leads to illegal activities. 80% of addicted women turn to prostitution. Methadone has been used for substitution in the US. In Germany, levomethadone (L-Polamidon) is approved and has a half time of 29 hours which is much longer than that of heroin. The heroin substitution regime consists of 4-5 ml of levomethadone and later 1-3 drops/day. Asphyxia of the fetus could occur in unmedicated withdrawal, necessitating the use of levomethadone even during pregnancy. The reduction of .2 ml of this drug every 2 days was well tolerated. Outpatient drug treatment is risky, it should be carried out only in maternal-child care facilities.     

Cancer of the stomach, pregnancy and labor]

The authors describe a case of gastric carcinoma coupled with pregnancy, the only such case they encountered in 80,064 deliveries over a period of 30 years. The pregnancy was complicated by pronounced anemia and general weakness. By administering roborants, antianemic therapy, and blood transfusion to improve the patient's general condition, the pregnancy was completed by the birth of a clinically healthy at-term live child, weighing 3150 g. The patient lived only 6 months after delivery.     

Chickenpox and pregnancy]

The authors report a case of chickenpox exposure during the first three months of pregnancy. Ultrasonographic monitoring of the fetus revealed signs of fetal infection starting from 32 weeks of amenorrhea (hepatomegaly, ascites, pleural effusion) but clinical examination of the child at birth showed nothing abnormal. The diagnosis was confirmed by the development of herpes zoster in the child after birth. The difficulty of determining a fetal prognosis during pregnancy is emphasised.     

Lymphogranulomatosis and pregnancy]

Four cases in lymphogranulomatosis and pregnancy are presented and compared to the opinions of other authors. Though a lot of questions are unknown yet, it seems that pregnancy doesn't have an unfavourable weight with lymphogranulomatosis.     

Pathological and clinical study on 80 cases of liver disease in pregnancy]

Ninety-seven cases of liver disease in pregnancy confirmed by pathological examination were studied. The results showed that in addition to virus hepatitis (58.8%), which was the leading cause, there were quite a proportion of other liver diseases. Among these acute fatty liver of pregnancy accounted for 18.6%, intrahepatic cholestasis of pregnancy were 16.5%. The causes of misdiagnosis and the bases for differential diagnosis were discussed. It was considered that early pathological examination of liver and other morphological study were important in diagnosis of liver diseases in pregnancy.     

Myoma and pregnancy]

According to Kayser myomas occur in 20% of all women over the age of 35. Such patients require special attention from their obstetrician. Although the presence of small myomas may not necessarily interfere with the pregnancy, they can start to grow quite rapidly at this time. In such cases the rates of abortion and premature birth are enhanced and there are often serious puerperal complications. It is therefore recommended that the nodes are enucleated during early pregnancy. Here a 20% abortion rate is to be expected. In the case of large myomas it is necessary for postpartum to be supervised individually. Here two cases are reported, one conservative with long puerperium and one operative with twin pregnancy. Both patients were discharged with healthy infants.