Nikolov A, Surchev Zh, Nalbanski B, Diavolov V, Dimitrov A
Akush Ginekol (Sofiia). 2008;47(2):3-10.
The aim of the study is following up the pregnancy and delivery in women with cerebrospinal fluid shunts for hydrocephalus.
The study includes 12 pregnant women (9 nuliparous and 3 multiparous) ranging in age from 19 to 36 years which were initially shunted prior to the pregnancy. 9 of the patients had VP shunts and 3 with VA shunt. They were followed up for evolution of the pregnancy, the state of the shunts and the method of delivery.
It was found that the cerebrospinal fluid shunts does not affect the pregnancy outcome. Women with revision of the shunt during the pregnancy were not included in this study. We had 1 case of spontaneous abortion in 26 gestational week and two cases of preterm vaginal delivery. The other included in the study patients have live term births- 5 with vaginal delivery and 4 with caesarean sections. Spinal and epidural analgesia and general anesthesia was performed. Only in one case was performed revision and substitution of the shunt 6 weeks after the delivery due to obturation of the distal part of the shunt.
Presence of cerebral shunt does not affect essentially the pregnancy development. The vaginal delivery in women with cerebrospinal fluid shunts can be provide successfully with analgesic medicines that does not increase the intracranial pressure. The caesarean section should be performed by obstetrical indications and in cases with increased intracranial pressure.
本研究的目的是随访患有脑积水并接受脑脊液分流术的女性的妊娠和分娩情况。
本研究纳入12名孕妇(9名初产妇和3名经产妇),年龄在19至36岁之间,她们在妊娠前最初接受了分流术。其中9例患者接受了脑室腹腔分流术(VP分流术),3例接受了脑室心房分流术(VA分流术)。对她们进行随访,观察妊娠进展、分流器状态及分娩方式。
发现脑脊液分流术不影响妊娠结局。本研究未纳入孕期进行分流器翻修的女性。我们有1例在孕26周时自然流产,2例早产经阴道分娩。其他纳入研究的患者足月分娩——5例经阴道分娩,4例剖宫产。采用了脊髓和硬膜外镇痛以及全身麻醉。仅1例在产后6周因分流器远端堵塞进行了分流器翻修和置换。
脑分流器的存在本质上不影响妊娠进展。对于患有脑脊液分流术的女性,使用不增加颅内压的镇痛药可以成功实现经阴道分娩。剖宫产应根据产科指征以及颅内压升高的情况进行。