Abstract P312: The Impact of Arterial Hypertension in Maternal and Perinatal Outcomes in Pregnancies With Takayasu Arteritis

Objectives: To describe the clinical features, obstetric and perinatal outcomes of pregnancies in patients diagnosed Takayasu arteritis associated to arterial hypertension. Methods: A retrospective, observational and descriptive study evaluating pregnant patients at a Brazilian tertiary hospital between the years 2002 and 2016 that had been diagnosed with Takayasu arteritis (TA) based on the modified Ishikawa criteria. Arterial hypertension (AH) previous to pregnancies was considered as BP≥ 140/90 mmHg or under treatment. The variables considered for analysis were clinical characteristics, diagnostic criteria, obstetrics and perinatal outcomes of these pregnancies. Results: Twenty-nine pregnancies in 24 patients were followed in the period. Hypertension was detected in 20 patients (83.3%). The most prevalent angiographic criteria were injury in the abdominal aorta, found in 15 women (62.5%). Angiographic classification type 5 was the most common feature. Aside from two drop-outs that were not followed up, the pregnancies resulted in 25 live births. Five (20%) of the newborns were classified as small for gestational age and eight (32%) were premature, most of them in patients with AH. Eighteen deliveries (69.2%) were caesarean sections and the main anesthetic method was the combined spinal-epidural. Preeclampsia was the main maternal complication, present in five cases, all of them with previous diagnosis of AH. There were no acute cardiovascular complications during pregnancy related to underlying disease. The only fetal death in this study was an abortion after judicial authorization by lethal fetal malformation. Conclusion: In general, patients with TA had a good perinatal outcomes despite of severity of disease. Hypertension is highly prevalent and is related to major reported obstetric and perinatal complications, such as preeclampsia, prematurity and newborns that are small for gestational age.