Management for pregnancy and delivery in patients with a history of Kawasaki disease

: We report the results of pregnancy and delivery in patients with coronary artery lesions caused by Kawasaki disease. The mode of delivery should be primarily determined by obstetrical considerations, rather than the coronary arterial lesions caused by Kawasaki disease. An assisted second stage of labor using epidural anesthesia is recommended in patients with a low left ventricular ejection fraction and significant localized stenosis of a coronary artery. However, if the patients are symptomatic or they have ischemic sign, Caesarean section should be recommended based on their general condition. A holter electrocardiogram at the third trimester is useful for decision of the mode of delivery. Aspirin at low doses is considered to be safe during pregnancy and delivery.