Pregnancy in women with a history of Kawasaki disease: management and outcomes.
BJOG
; 121(11): 1431-8, 2014 Oct.
Article
en En
| MEDLINE
| ID: mdl-24597833
ABSTRACT
OBJECTIVE:
To characterise the obstetrical management and outcomes in a series of women with a history of Kawasaki disease (KD) in childhood.DESIGN:
Retrospective case series.SETTING:
Tertiary healthcare setting in the USA. POPULATION Women with a history of KD in childhood.METHODS:
Women completed a detailed health questionnaire and participated in research imaging studies as part of the San Diego Adult KD Collaborative Study. MAIN OUTCOMEMEASURES:
Obstetrical management, complications during pregnancy and delivery, and infant outcomes.RESULTS:
Ten women with a history of KD in childhood carried a total of 21 pregnancies to term. There were no cardiovascular complications during labour and delivery despite important cardiovascular abnormalities in four of the ten subjects. Pregnancy was complicated by pre-eclampsia and the post-partum course was complicated by haemorrhage in one subject each. Two of the 21 progeny subsequently developed KD.CONCLUSIONS:
Women with important cardiovascular sequelae from KD in childhood should be managed by a team that includes both a maternal-fetal medicine specialist and a cardiologist. Pre-pregnancy counselling should include delineation of the woman's current functional and structural cardiovascular status and appropriate adjustment of medications, but excellent outcomes are possible with appropriate care. Review of the English and Japanese literature on KD and pregnancy revealed the occurrence of myocardial infarction during pregnancy in women with missed KD and aneurysms that were not diagnosed until their acute event. Our study highlights the need for counselling with regard to the increased genetic risk of KD in offspring born to these mothers.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Preeclampsia
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Complicaciones Cardiovasculares del Embarazo
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Calcinosis
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Parto Obstétrico
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Madres
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Síndrome Mucocutáneo Linfonodular
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Middle aged
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Pregnancy
Idioma:
En
Revista:
BJOG
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Estados Unidos