期刊
JOURNAL OF NEUROSURGERY
卷 118, 期 1, 页码 50-55出版社
AMER ASSOC NEUROLOGICAL SURGEONS
DOI: 10.3171/2012.8.JNS12241
关键词
pregnancy; puerperium; hemorrhage risk; sporadic cerebral cavernous malformation; vascular disorders; familial cerebral cavernous malformation
Object. The threat of symptomatic hemorrhage from cerebral cavernous malformations (CCMs) during pregnancy remains poorly understood. The authors undertook this study to better define the risk of pregnancy-related hemorrhage in this population. Methods. The records of female patients with sporadic (isolated lesions and negative family history) and familial forms of CCM, which were collected as part of the Barrow Neurological Institute CCM natural history study, were examined. Clinical data related to pregnancy, including type of delivery (vaginal or cesarean section) and any change in neurological status, were obtained from chart reviews and patient interviews. Results. There were 168 pregnancies among 64 female patients with CCM (28 sporadic and 36 familial). Assuming an average of 46 weeks per pregnancy (40 weeks of gestation and 6 weeks of puerperium), patients were at risk for hemorrhage for a total of 148.6 years. Symptomatic hemorrhage (defined as new-onset or exacerbation of seizure activity or any change in neurological status) occurred during 5 pregnancies, with the most common symptom being seizures (4 cases). The overall risk for symptomatic hemorrhage was 3% per pregnancy; the risk was 1.8% per pregnancy in the sporadic group and 3.6% per pregnancy in the familial patients. There were 19 deliveries by cesarean section: 5 for obstetrical reasons, 8 for fear of possible hemorrhage, and 6 for unknown reasons. Vaginal delivery was performed without complications for the remaining 149 pregnancies. Conclusions. The authors' experience suggests that the risk of symptomatic hemorrhage from a CCM during pregnancy is not increased and that a history of CCM is not a contraindication to pregnancy or vaginal delivery. (http://thejns.org/doi/abs/10.3171/2012.8.JNS12241)
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据