Multidisciplinary management including anticoagulation and low-dose aspirin can lead to favorable maternal and fetal outcomes in pregnant women with coronary artery aneurysms from Kawasaki disease.
Supports multidisciplinary anticoagulation in Kawasaki pregnancies; hypothesis-generating, should not yet change practice.
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.
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M et al. (2016) studied this question.
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