Case Report

 

A 30 year old primigravid patient diagnosed with 

Takayasu Arteritis at 16

At time of diagnosis she had complete obliteration of radial and brachial pulses with decreased right carotid pulse 

on doppler.

The patient was on prednisolone, tocilizumab, 

aspirin, omeprazole, calcium and vitamin D prior to 

pregnancy.

She had serial growth scans and a OGTT to screen for 

gestational diabetes which was normal. 

The patient transferred care between hospitals, 

so at 38 weeks a MRA was performed which 

remained unchanged from previous imaging carried out in 

2017 which showed narrowing in the distal right subclavian artery MRA image in figure 1. 

The patient delivered a healthy baby boy vaginally at 39 weeks following induction.

 

 

 

MDT Plan

• Blood pressure monitoring- to ensure no fluctuations in blood pressure, leading to aneurysm rupture or lead to cerebral ischaemia

• Early epidural- to ensure no fluctuations in blood pressure

• IV hydrocortisone in labour

• Avoid ergometrine in event of PPH- due to risk of raising blood pressure

Induction of labour at 39 weeks

 

 

Conclusion

Takayasu arteritis is a large vessel vasculitis, which commonly affects young women under 40 years old. 

Having adequate blood pressure control and disease activity reduced to a minimum is vital to ensure safe outcomes for mother and foetus, with a close collaboration between the MDT.