Successful Maternal and Fetal Outcome in Patients with Takayasu Arteritis: Two Rare Case Reports

Abstract

Takayasu's arteritis is a rare, chronic, idiopathic inflammatory illness of the large arteries that mostly affects the aorta, its primary branches, and the coronary and pulmonary arteries. It is mostly seen among women with child bearing age group (80%). It is suggested that pregnancy, however not usually associated with an exacerbation of inflammatory vascular lesions, should only be considered during a phase of remission. Increased intravascular volume during pregnancy impairs circulation and worsens aortic regurgitation, hypertension, and congestive heart failure. One of the serious complications that can develop is hypertension, which can lead to intrauterine growth restriction, maternal heart failure, and foetal haemorrhage during the postpartum period. The anaesthetic management of patients with Takayasu arteritis undergoing casesarean delivery is challenging. The challenges may be multiplied if patient is also suffering from SARS-CoV-2 (COVID-19) infection reported in few recent studies. However, caesarean section in uncomplicated Takayasu arteritis can be managed safely under spinal anaesthesia.