妊娠女性高松动脉炎的母胎结局:10年以上的单中心经验

Burcu YAĞIZ, Belkıs Nihan COŞKUN, Orkun SAKAR, Hüseyin Ediz DALKILIÇ, Yavuz PEHLİVAN
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摘要

背景:本研究旨在评估孕妇患高松动脉炎(Takayasu’s arteritis, TA)的母婴结局。材料和方法:该研究包括2003年至2021年期间诊断为TA的50名患者中诊断时或之后的10名孕妇。通过医院记录和电话访谈获取10例患者的21例妊娠结局。由于诊断前的时机,排除了两次妊娠。 结果:根据血管造影分类,1型6例,2b型2例,1+4型2例。63.15%的妊娠是计划妊娠,而风湿病专家认可的比例为42.10%。19例妊娠中有16例(84.2%)为活产,3例(15.7%)为流产,19例妊娠中有2例(10.5%)为新生儿死亡。在19例妊娠中,有5例(26.3%)在妊娠期间发病。两名新生儿死亡来自于两名在怀孕期间被诊断为子痫前期的患者。既往高血压和活动性疾病是这两例患者的共同特征。经过一年的随访,6名孕妇(31.5%)有活动性疾病,4名孕妇(66.6%)在怀孕前和怀孕期间都有活动性疾病。虽然胎儿数据分析显示没有先天性异常,但有4例妊娠导致出生体重过低和宫内生长迟缓(21.05%)。结论:应考虑发生先兆子痫和新生儿死亡的风险,特别是对于在活动性疾病期间怀孕的已有高血压的TA患者。
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Maternal and fetal outcomes in pregnant women with Takayasu’s arteritis: single center experience over ten years
Background: This study aims to assess pregnant women's maternal and fetal outcomes with Takayasu’s arteritis (TA). Material and Methods: The study comprised ten pregnant women at the time of diagnosis or afterwards among the 50 patients diagnosed with TA between 2003 and 2021. Twenty-one pregnancy outcomes of 10 patients were obtained from hospital records and telephonic interviews. Two pregnancies were excluded due to timing before diagnosis. Results: Based on the angiographic classification, six patients had type 1, two had type 2b, and two had type 1+4 TA. 63.15% of pregnancies were planned, and the rheumatologist approved 42.10%. Live birth occurred in 16 (84.2%) of 19 pregnancies, three pregnancies (15.7%) resulted in abortion and two (10.5 %) of 19 pregnancies ended in neonatal death. In five (26.3%) of the 19 pregnancies, the disease was activated during pregnancy. Two neonatal deaths were from the two patients diagnosed with preeclampsia during pregnancy. Pre-existing hypertension and active disease are shared features of these two patients. After one year of follow-up, six pregnancies (31.5%) had active disease, and four (66.6%) had active disease both before and during pregnancy. While fetal data analysis revealed no congenital anomalies, four pregnancies resulted in low birth weight and intrauterine growth retardation (21.05%). Conclusions: The risk of developing preeclampsia and neonatal death should be considered, especially in TA patients with pre-existing hypertension who become pregnant during active disease.
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