Epidural anaesthesia for Caesarean section in a patient with severe Takayasu's disease

Takayasu's arteritis or disease is a rare, idiopathic, chronic inflammatory disease which causes narrowing, occlusion or aneurysms of blood vessels. It preferentially affects large arteries such as the aorta and its branches and hence its alternative names of pulseless disease, occlusive thromboaortopathy or aortic arch syndrome. Although most commonly found in oriental women, it occurs sporadically throughout the world. We present the case of an elderly primigravida with long-standing Takayasu's disease complicated by hospital and needle phobia who underwent a successful Caesarean section under epidural anaesthesia. Her management is discussed in the light of current opinion regarding pregnancy and Takayasu's disease.