Clinical Analysis of Pregnancy Combined with Cerebral Cavernous Malformations in 15 Cases
10.11969/j.issn.1673-548X.2024.05.031
- VernacularTitle:妊娠合并颅内海绵状血管瘤15例临床分析
- Author:
Hui ZHANG
1
;
Houyuan LV
;
Baile LI
Author Information
1. 100053 北京,首都医科大学宣武医院妇产科
- Keywords:
Pregnancy;
Cerebral cavernous malformations;
Cerebral hemorrhage;
Epilepsy;
Multi-disciplinary team management
- From:
Journal of Medical Research
2024;53(5):154-157,37
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics and outcome of pregnancy combine with cerebral cavernous malforma-tion(CCM),and to investigate the management during perinatal period of pregnancy combine with CCM.Methods A total of 15 cases of pregnancy combine with CCM were admitted to Xuanwu Hospital,Capital Medical University from August 2015 to August 2022.A ret-rospective analysis was performed on the data.Results The 15 patients had a total of 16 pregnancies and CCM were found in pre-preg-nancy examination.The initial manifestations were epilepsy in 5 cases,sudden headache in 4 cases,headache due to cerebral hemorrhage in 1 case,transient syncope in 1 case,ataxia in 1 case and no clinical symptoms in 3 cases.Among the clinical manifestations of epilep-sy,4 patients were relieved or disappeared after treated by operation or radiotherapy before pregnancy,1 patient without treatment had fre-quent seizures during pregnancy and disappeared after increasing drug dosage.No new cases of operation and cerebral hemorrhage during pregnancy.3 cases had vaginal delivery and 11 cases selected cesarean section after 37 weeks of labor and 1 case required termination of pregnancy at the week of 18 weeks.1 patient suffered status epilepticus after postpartum,and the remaining cases were healthy.Conclu-sion Pregnancy combine with CCM needs multi-disciplinary team(MDT)management.Pregnancy may increase the risk of epilepsy.Risk assessment should be performed by neurosurgery department before pregnancy,and antiepileptic drugs should be adjusted during pregnancy,Close monitoring after delivery is also important.The mode of delivery is decided after discussion and evaluation by the MDT team composed of obstetrics,neurology,anesthesiology and maternal-fetal medicine.
