Management of Acute Hemorrhage Caused by Cerebral Arteriovenous Malformation During Pregnancy–Case Series and Literature Review

Zhong, Zhihong; Ni, Hui; Jing-ci, Zhu; Jiang, Hong; Hu, Jie; Lin, Donghai; Bian, Liuguan

doi:10.1016/j.wneu.2021.06.002

Cited by 3 publications

(2 citation statements)

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“…Ruptured pial AVM in pregnancy is a rare but extraordinarily complex situation, associated with high maternal and fetal mortality [5,11]. Most bAVMs occur in the supratentorial region [11], but, in our case, the AVM was located in the infratentorial region. This location of the AVM is usually more difficult to treat surgically.…”

Section: Discussionmentioning

confidence: 60%

“…Because of the high rate of rebleeding, the alarming maternal mortality rate from rebleeding (up to 28%), and the 14% fetal death rate, the treatment of ruptured bAVMs should not be delayed and must be actively managed [5]. The intervention of ruptured bAVMs is recommended within 2 weeks after initial bleeding in patients of gestational age < 34 weeks, while termination of pregnancy as soon as possible followed by timely intervention of ruptured bAVMs is practicable in patients of gestational age ≥ 34 weeks [11].…”

Section: Introductionmentioning

confidence: 99%

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Embolization of Ruptured Infratentorial Pial AVM in Pregnancy

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Kolarovszki

et al. 2023

Life

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A primigravida 22-year-old woman, at a gestation of 23 weeks, experienced bleeding from a pial arteriovenous malformation (AVM) located in the right cerebellum. After interdisciplinary consensus and with the informed consent of the patient and her family, AVM embolization was performed. Complete occlusion of the AVM was achieved by embolization with PHIL (precipitating hydrophobic injectable liquid). The calculated dose in the uterus was less than 1 µSv, which represents a negligible risk of harmful effects on the fetus. She delivered a baby at 37 weeks of gestation by cesarean section without complications. No congenital disorders were diagnosed by standard screening methods until the age of the newborn was two years. The angiography protocol must be optimized to minimize the radiation dose. Adequate shielding protection of the uterus is important. Premature termination of pregnancy is not necessary. Multidisciplinary care of neurologists, neurosurgeons, interventional radiologists, anesthesiologists, neonatologists, and obstetricians is necessary.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%