Indications for peripartum aortic pressure monitoring in Takayasu's disease. A patient with past history of intrapartum cerebral hemorrhage.

ABSTRACT

We describe a successful delivery by prophylactic cesarean section in a patient with Takayasu's disease who had a previous history of intrapartum cerebral hemorrhage during vaginal delivery. Aortography showed occlusion of the common carotid, subclavian and vertebral arteries on the left side, severe narrowing of the right subclavian artery, and moderate narrowing of the entire abdominal aorta. Blood pressure was managed by monitoring central aortic pressure at the thoracic aorta. During the peripartum course, we recommend monitoring the central aortic pressure in patients with Takayasu's disease in whom accurate blood pressure readings can not be obtained in any extremity.