{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:05:49Z","timestamp":1768280749738,"version":"3.49.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>Approximately half of Kawasaki disease patients are expected to have transitioned to adulthood, and an increasing number of patients with cardiovascular sequelae have gotten pregnant. Management of women with Kawasaki disease who have residual coronary artery disease is poorly established. Thus, we conducted detailed analysis of these cases.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We reviewed 19 pregnancies in 13 such women in two tertiary perinatal facilities, Saitama Medical Center and National Cardiovascular Center. The medical records were reviewed in all women with Kawasaki disease and coronary artery lesion between 1998 and 2015, with regard to age of diagnosis, types of coronary artery lesion, location, previous treatment, pregnancy course and medical management for coronary lesion, cardiac function, and planned mode of delivery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Fourteen parturients attempted vaginal delivery, and all but one received neuraxial analgesia, providing stable hemodynamics. Four elective and two emergency cesarean deliveries were performed due to obstetric indications, while one woman required cesarean delivery at preterm due to maternal cardiac indication.<\/jats:p>\n<jats:p>Among 14 attempted vaginal deliveries, instrumental vaginal delivery was performed in 50%. Cardiac events were noted in four women, all in post-partum period, such as non-sustained ventricular tachycardia or chest discomfort without ECG changes. Antithrombotic medication was exclusively low dose aspirin in 11 of 19 pregnancies (58%), and none received anticoagulation during pregnancy or delivery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our case series support the practice of preferred vaginal delivery, with neuraxial labor analgesia in indicated patients, while highlighting the need for vigilance in the post-partum period.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40981-020-00375-y","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T16:03:59Z","timestamp":1599494639000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of pregnancy and delivery in women with Kawasaki disease and residual coronary artery lesion with detailed analysis of labor analgesia: combined experience of 13 cases in two institutions"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-9491","authenticated-orcid":false,"given":"Rie","family":"Inoue","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Mazda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayo","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Yoshimatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumi","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuo","family":"Terui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"375_CR1","first-page":"178","volume":"16","author":"T Kawasaki","year":"1967","unstructured":"Kawasaki T. Acute febrile mucocutaneous syndrome with lymphoid involvement with specific desquamation of the fingers and toes in children. JPN Arerugi. 1967;16:178\u2013222.","journal-title":"JPN Arerugi"},{"key":"375_CR2","doi-asserted-by":"publisher","first-page":"216","DOI":"10.2188\/jea.JE20110126","volume":"22","author":"Y Nakamura","year":"2012","unstructured":"Nakamura Y, Yashiro M, Uehara R, et al. Epidemiologic features of Kawasaki disease in Japan: results of the 2009-2010 nationwide survey. J Epidemiol. 2012;22:216\u201321.","journal-title":"J Epidemiol"},{"key":"375_CR3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.jpeds.2012.12.011","volume":"163","author":"SK Huang","year":"2013","unstructured":"Huang SK, Lin MT, Chen HC, et al. Epidemiology of Kawasaki disease: prevalence from national database and future trends projection by system dynamics modeling. J Pediatr. 2013;163:126\u201331.","journal-title":"J Pediatr."},{"key":"375_CR4","first-page":"412","volume":"69","author":"K Nakamura","year":"2011","unstructured":"Nakamura K, Yashiro M, et al. Epidemiology of fatal cases with Kawasaki Disease. Cardioangiology. 2011;69:412\u201320.","journal-title":"Cardioangiology."},{"key":"375_CR5","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1017\/S1047951106000126","volume":"16","author":"E Tsuda","year":"2006","unstructured":"Tsuda E, Kawamata K, Neki R, et al. Nationwide survey of pregnancy and delivery in patients with coronary arterial lesions caused by Kawasaki disease in Japan. Cardiol Young. 2006;16:173\u20138.","journal-title":"Cardiol Young"},{"key":"375_CR6","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1111\/1471-0528.12685","volume":"121","author":"CT Gordon","year":"2014","unstructured":"Gordon CT, Jimenez-Fernandez S, Daniels LB, et al. Pregnancy in women with a history of Kawasaki disease: management and outcomes. BJOG. 2014;121:1431\u20138.","journal-title":"BJOG."},{"key":"375_CR7","unstructured":"Guidelines for diagnosis and management of cardiovascular sequelae in Kawasaki disease (JCS2013). http:\/\/www.j-circ.or.jp\/guideline\/pdf\/JCS2013_ogawas_h.pdf. Accessed 6 Mar 2020."},{"key":"375_CR8","unstructured":"Guidelines for management of congenital heart disease in adults (JCS 2017) The Japanese Circulation society. http:\/\/www.j-circ.or.jp\/. Accessed 6 Mar 2020."},{"key":"375_CR9","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s002460010180","volume":"22","author":"K Takahashi","year":"2001","unstructured":"Takahashi K, Oharaseki T, Naoe S, et al. Pathological study of postcoronary arteritis in adolescents and young adults: with reference to the relationship between sequelae of Kawasaki disease and atherosclerosis. Pediatr Cardiol. 2001;22:138\u201342.","journal-title":"Pediatr Cardiol"},{"key":"375_CR10","first-page":"1518","volume":"72","author":"Y Yokouchi","year":"2014","unstructured":"Yokouchi Y, Oharaseki T, Katsuzaki J, et al. Pathology of coronary artery in Kawasaki disease. Nippon Rinsho. 2014;72:1518\u201321.","journal-title":"Nippon Rinsho."},{"key":"375_CR11","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1054\/ijoa.2000.0723","volume":"9","author":"P McAndrew","year":"2000","unstructured":"McAndrew P, Hughes D, Adams P, et al. Pregnancy and Kawasaki disease. Int J Obstet Anesth. 2000;9:279\u201381.","journal-title":"Int J Obstet Anesth."},{"key":"375_CR12","unstructured":"Guideline on indication and management of pregnancy and delivery in women with heart disease (JCS 2018) Japanese Circulation Society \/ Japanese Obstetrics and Gynecology Association Joint Guidelines. http:\/\/www.j-circ.or.jp\/ accessed 6 March 2020."}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-020-00375-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-020-00375-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-020-00375-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T23:09:59Z","timestamp":1630969799000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-020-00375-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,7]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["375"],"URL":"https:\/\/doi.org\/10.1186\/s40981-020-00375-y","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,7]]},"assertion":[{"value":"9 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study protocol was approved by IRBs of Saitama Medical Center (#1010) and National Cerebral and Cardiovascular Center (M25-026). We waived individual consent, which was approved by the IRBs.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors reviewed, revised, and approved the manuscript as well as consent for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors have no financial conflict of interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"67"}}