Department of Neurological Surgery, Tulane University, New Orleans, LA, USA.
Department of Neurological Surgery, Ochsner Medical Center, New Orleans, LA, USA.
Neurosurg Rev. 2021 Oct;44(5):2511-2522. doi: 10.1007/s10143-020-01457-2. Epub 2021 Jan 7.
Aneurysmal subarachnoid hemorrhage (aSAH) is an emergent condition requiring rapid intervention and prolonged monitoring. There are few recommendations regarding the management of aSAH in pregnancy. We identified all available literature and compiled management decisions as well as reported outcomes through a systematic literature review without meta-analysis to provide recommendations for management of aSAH during pregnancy. We included a total of 23 articles containing 54 cases of pregnancy-related aSAH in our review. From these reports and other literature, we evaluated information on aSAH pathophysiology, diagnosis, and management with respect to pregnancy. Early transfer to an appropriate facility with neurocritical care, a high-risk obstetric service, and a neurosurgery team available is crucial for the management of aSAH in pregnancy. Intensive monitoring and a multidisciplinary approach remain fundamental to ensure maternal and fetal health.
颅内动脉瘤性蛛网膜下腔出血（aSAH）是一种需要迅速干预和长时间监测的紧急情况。目前针对妊娠合并 aSAH 的管理仅有少量建议。我们通过系统文献回顾（无荟萃分析），在检索所有可用文献的基础上，汇总了管理决策和报道结局，以提供妊娠期间 aSAH 管理的建议。我们的综述共纳入 23 篇文章，其中包含 54 例与妊娠相关的 aSAH。通过这些报告和其他文献，我们评估了 aSAH 病理生理学、诊断和管理方面与妊娠相关的信息。对于妊娠合并 aSAH 的管理，早期转至具有神经重症监护、高危产科服务和神经外科团队的合适机构至关重要。强化监测和多学科方法仍然是确保母婴健康的基础。
