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Pre-existing, incidental and hemorrhagic AVMs in pregnancy and postpartum: Gestational age, morbidity and mortality, management and risk to the fetus

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Tiantan Xili 6, Beijing 100050, Peoples R China
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关键词: Arteriovenous malformation pregnancy postpartum

摘要:
Objective: The objective of this article is to analyze the maternal and fetal outcomes of pregnancies that present with arteriovenous malformations (AVMs). Methods: A literature review was performed that analyzed 65 cases of AVM during pregnancy previously reported in English literature. Results: Sixty-five cases of pregnancy-associated AVM were identified. The patients' ages ranged from 16 to 45 years, with a mean of 28 +/- 4.9 years. Sixteen cases (24.6%) were pre-existing AVMs. There were 54 cases (83.1%) of AVM ruptured during pregnancy and postpartum: Six cases (11.1%) were in the first trimester, 24 (44.4%) were in the second, 22 (40.7%) were in the third trimester and two (3.7%) were postpartum. Unfavorable maternal clinical outcome (modified Rankin Scale (mRS) >= 2) was identified in 20 cases (30.8%) and abortion occurred in 10 cases (15.4%). There were three maternal deaths, yielding a case mortality rate of 4.6%. Fifty-three fetuses were born via cesarean section in 42 cases and vaginal delivery in 10 cases; 48 were in good health, three were temporarily intubated, one was macrosomic and one died. In univariate analysis, AVM hemorrhage presentation was significantly associated with a poor maternal outcome (mRS >= 2) (p = 0.030); however, not significantly associated with fetus risk (p = 0.864). Gestational age was not significantly associated with poor maternal outcome (p = 0.875) or fetal risk (p = 0.790). Conclusion: AVM hemorrhage presentation was significantly associated with poor maternal outcome. Pre-existing ruptured AVM may not be associated with fetal risk. Gestational age of AVM rupture was not significantly associated with poor maternal outcome or fetal risk.

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出版当年[2015]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
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出版当年[2014]版:
Q4 CLINICAL NEUROLOGY Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q3 CLINICAL NEUROLOGY Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Q4 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Tiantan Xili 6, Beijing 100050, Peoples R China
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通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Tiantan Xili 6, Beijing 100050, Peoples R China
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