Rapport de cas en gynécologie et obstétrique Libre accès

Abstrait

Pregnancy Management of Women with Coronary Artery Aneurysm Due to Kawasaki Disease During Childhood: Case Report and Review of the Literature

Peers de Nieuwburgh M, Sluysmans T and Hubinont C

Kawasaki disease (KD) is an acute systemic vasculitis occurring during childhood. It could be associated with persistent heart defects such as coronary artery aneurysms (CAA). During pregnancy, there is a theoretical high risk of full myocardial infarction and sudden death. Guidelines do not exist but case report studies found in the literature show that these pregnancies could have a good maternal and fetal outcome dependent upon a careful follow pre-conceptional counselling is important for evaluating the cardiological risk factors. Maternal cardiovascular complications are rare when anticoagulation therapy is given. Low dose aspirin is safe and prescribed to patients with coronary aneurysms. For the management of labour and delivery, assisted second stage of labour with locoregional anesthesia is recommended. C-sections should be offered only to patients with severe cardiological conditions or for obstetrical reasons. In conclusion, multidisciplinary team management of pregnant patients with KD sequellae remains a challenge but is essential for a favourable outcome of the pregnancy.