Case Report : General anesthesia for emergency cesarean delivery in a parturient with Takayasu’s arteritis

Abstract

Background: Takayasu’s arteritis (TA) is an
idiopathic, chronic inflammatory disease which
causes stenosis or occlusion of aorta and its
branches. Uncontrolled hypertension with end-organ
dysfunction, inadequacy of distal organ circulation
and thrombosis are significant consequence.
Incidence of TA is 2.6 per million per year and
frequently found in young eastern woman (9:1).
Normally, pregnancy does not have a deleterious
effect on the natural progression of the disease.
However, physiologic change during pregnancy
increases risk of hypertensive complications such as
preeclampsia, exacerbation of chronic hypertension,
intrauterine growth retardation or fetal death.
Moreover, patient with TA increases risk of cesarean
delivery due to uncontrolled hypertension and fetal
distress. Therefore, it’s crucial to understanding the
pathophysiology and clinical course of the disease,
which are the major concern in anesthetic management
for cesarean delivery in parturient with TA.