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Kawasaki Disease With Coronary Artery Sequelae

From the Departments of ¹Obstetrics and Gynecology and ²Medicine, University of Illinois at Chicago, Chicago, Illinois.

BACKGROUND: Kawasaki disease is an acute febrile illness characterized by mucosal inflammation, skin rash, and cervical lymphadenopathy, with potential for cardiac sequelae, including coronary aneurysms with subsequent thrombosis, infarction, and death. Pregnancy in affected women presents multiple maternal risks.

CASE: A woman with Kawasaki disease complicated by coronary aneurysms underwent two consecutive pregnancies without further difficulty. She was maintained on therapeutic enoxaparin, alpha-methyldopa, and labetalol, with labor induction, passive second stage, and continued anticoagulation for 6 weeks postpartum. During gestations she was assessed with echocardiography, electrocardiography, and cardiac event monitor and managed by a maternal–fetal medicine and cardiology team.

CONCLUSION: Kawasaki disease with coronary aneurysms presents challenges for obstetric management; obstetricians should be familiar with the disease, implications, and management in pregnancy.