Arterite de Takayasu na gestação: relato de caso e revisão de literatura

Arterite de Takayasu na gestação: relato de caso e revisão de literatura

Alternative title Takayasus's arteritis in pregnancy: case report and literature review
Arteritis de Takayasu en el embarazo: relato de caso y revisión de la literatura
Author Leal, Plínio da Cunha Autor UNIFESP Google Scholar
Silveira, Fernanda Fabrizia Martins Autor UNIFESP Google Scholar
Sadatsune, Eduardo Jun Autor UNIFESP Google Scholar
Clivatti, Jefferson Autor UNIFESP Google Scholar
Yamashita, Americo Masafuni Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background and objectives: Takayasus's Arteritis (TA) is a chronic, inflammatory, progressive, idiopathic disease that causes narrowing, occlusion, and aneurysms of systemic and pulmonary arteries affecting especially the aorta and its branches. During pregnancy, one should pay special attention to these patients. The objective of this report was to present the peripartum anesthetic care of a patient with TA and a review of the literature.Case report: This is a 31-year old gravida who underwent exchange of the aortic arch and placement of a metallic aortic valve for TA four years ago. She had no complications during pregnancy, and she was admitted at 34 weeks of pregnancy for anticoagulation management. Elective cesarean section was performed at 39 weeks with continuous epidural anesthesia. Fractionated doses of local anesthetic were administered to guarantee slow installation of the blockade. The patient remained hemodynamically stable and was transferred to the ICU in the postoperative period.Conclusions: Several complications can affect gravidas with TA. Careful patient evaluation, treatment of TA complications, and anesthetic-surgical planning are fundamental. Maintenance of perfusion is the main concern in these patients, and neuraxial blocks may be used without harming the mother and fetus. In patients with compensated TA complications, monitoring does not differ from that routinely used in cesarean sections. Continuous epidural anesthesia with slow installation maintains hemodynamic stability and allows monitoring cerebral perfusion through the level of consciousness. To avoid postoperative hypoperfusion or hypertensive complications patients should be monitored in an intensive or semi-intensive care unit for 24 hours.
Keywords Takayasu Arteritis
Anesthesia, Obstetrical
Cesarean Section
Heart Valve Diseases
Language English
Date 2011-07-01
Published in Revista Brasileira De Anestesiologia. New York: Elsevier Science Inc, v. 61, n. 4, p. 479-485, 2011.
ISSN 0034-7094 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 479-485
Origin http://dx.doi.org/10.1590/S0034-70942011000400010
Access rights Open access Open Access
Type Review
Web of Science ID WOS:000292631400011
SciELO ID S0034-70942011000400010 (statistics in SciELO)
URI http://repositorio.unifesp.br/11600/45232

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