Can the Valsalva maneuver during delivery effort cause a recurrence of spontaneous intracranial hypotension?

Ferrante, Enrico; Rubino, G.; Ferrante, M.

doi:10.1016/j.ejogrb.2015.03.027

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…57 Unfortunately, the cause often remains undetermined. 58 A VM-induced retinopathy is a rare entity but has been reported following activities such as coughing, vomiting, straining on stool, yelling, blowing up an air mattress, weight lifting, moving furniture, Judo training, water skiing, vigorous exercise, motor vehicle accident, thoracic trauma, and difficult intubation. 59 The VM increases intraocular pressure leading to retinal or macular hemorrhage.…”

Section: Complications Associated With the Vmmentioning

confidence: 99%

Intraoperative Valsalva maneuver: a narrative review

Kumar

Zundert

2018

Can J Anesth/J Can Anesth

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The Valsalva maneuver (VM) involves expiratory effort against a closed mouth and/or glottis in the sitting or supine position with the increased intraoral and intrathoracic pressure raised to 40 mmHg for 15-20 sec after which the pressure is suddenly released and the breathing restored to normal. Complex cardiovascular and other physiologic changes occur during the VM. The VM has been used for diagnostic and therapeutic reasons as well as intraoperatively during specific surgical procedures. Although the VM is usually safe, rare complications have been reported. This review examines the published literature surrounding the VM and explores the physiologic changes that occur during its performance. Attempts have been made to understand its intraoperative uses and complications and how these can be prevented.

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Section: Complications Associated With the Vmmentioning

confidence: 99%

Intraoperative Valsalva maneuver: a narrative review

Kumar

Zundert

2018

Can J Anesth/J Can Anesth

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“…Three patients performed a cesarean section by their own free choice, although we neurologists and gynecologists recommended natural birth. Vaginal delivery is not contraindicated in pregnant women who had SIH during gestation; 25 however, Valsalva maneuver effort during vaginal delivery has been rarely reported as a causal factor of SIH 26 . In real‐world clinical practice, many centers recommend avoiding straining for a variable amount of time after EBP or dural repair.…”

Section: Resultsmentioning

confidence: 99%

Management of Spontaneous Intracranial Hypotension During Pregnancy: A Case Series

et al. 2020

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Background Spontaneous intracranial hypotension (SIH) is a rare condition resulting from cerebrospinal fluid (CSF) volume depletion, nearly always from spontaneous CSF leaks. CSF pressure in SIH is usually normal; low CSF pressure is found in a substantial minority of patients. SIH is uncommonly described in pregnancy. Case Series Five women with SIH during pregnancy have been conservatively treated adopting bed rest and overhydration. After prolonged conservative treatment, only 1 patient showed complete symptoms resolution. A rare SIH complication as cerebral venous thrombosis has been reported in 1 case. All 4 remaining patients had lumbar epidural blood patch (EBP) with symptoms disappearance. Conclusions EBP might be proposed to SIH patients also during pregnancy and after a brief period (~10 days) of ineffective conservative treatment, because it could allow faster symptoms improvement and complete recovery. Furthermore, EBP would avoid prolonged bed rest with the risk of SIH severe complications.

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“…The Valsalva maneuver may cause CSF leakage in patients with a weak dura mater [ 2 ]. Although vaginal delivery is not contraindicated in pregnant women with a history of SIH [ 7 ], SIH can be caused by the Valsalva maneuver even without epidural or spinal anesthesia or dural puncture during pregnancy [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Management of Labor and Anesthesia in a Patient With a History of Spontaneous Intracranial Hypotension: A Case Report With Literature Review

Nonaka,

Inomata

2024

Cureus

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Spontaneous intracranial hypotension (SIH) is a rare disorder characterized by continuous or intermittent cerebrospinal fluid (CSF) leakage from the CSF cavity, which causes symptoms such as headache or neck pain upon standing. However, no well-established measures concerning the type of delivery and anesthesia for pregnant women with a history of SIH have been reported. A woman had developed SIH 9 years earlier from lifting luggage into an overhead bin with stretching movements, which required continuous saline epidural infusion for recovery. Upon the patient’s pregnancy at the age of 35 years, although an elective cesarean section (CS) under general anesthesia was planned to avoid SIH recurrence, the patient had an emergency CS at 36 weeks. Since there is no prescribed method of delivery and anesthetic management for patients with a history of SIH, it is important to plan and adapt a treatment strategy based on the patient’s wishes and the institution’s protocols. As a sidenote, we reviewed the available literature regarding the type of delivery and anesthesia for pregnant women with a history of SIH.

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Can the Valsalva maneuver during delivery effort cause a recurrence of spontaneous intracranial hypotension?

Cited by 4 publications

References 6 publications

Intraoperative Valsalva maneuver: a narrative review

Intraoperative Valsalva maneuver: a narrative review

Management of Spontaneous Intracranial Hypotension During Pregnancy: A Case Series

Management of Labor and Anesthesia in a Patient With a History of Spontaneous Intracranial Hypotension: A Case Report With Literature Review

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