Fujita K, Tsunoda H, Shigemitsu S, Kubo T
Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki.
Nihon Sanka Fujinka Gakkai Zasshi. 1995 Dec;47(12):1359-64.
We studied twelve pregnancies in nine patients with arteriovenous malformation (AVM) managed at our hospital from January, 1984 to March, 1993. Three of the cases were diagnosed as subarachnoidal hemorrhage (SAH) and one as epilepsy during pregnancy. The AVM was resected surgically in two ruptured cases during pregnancy, and the fetus was delivered vaginally. In the other case of ruptured AVM delivery was by elective cesarean section. In the non-ruptured case delivery was vaginal. Two of the six patients who took an anticonvulsant developed hemolytic anemia, and one baby was born with a cleft lip and palete. We next retrospectively investigated 42 women who were followed up for AVM at the department of neurosurgery in our hospital from January, 1978 to March, 1995. Three pregnancies of a total of 46 pregnancies were complicated by a cerebral hemorrhage. The hemorrhage rate during pregnancy for women with unruptured AVM was 0.065 +/- 0.036 per person per year. There was no significant difference between the hemorrhage rate for pregnant women and that for nonpregnant women of childbearing age, and the risk for rupture of AVM was not increased in pregnancy.
我们研究了1984年1月至1993年3月在我院接受治疗的9例患有动静脉畸形（AVM）的患者的12次妊娠情况。其中3例在孕期被诊断为蛛网膜下腔出血（SAH），1例被诊断为癫痫。2例孕期AVM破裂的患者接受了手术切除AVM，胎儿经阴道分娩。另1例AVM破裂的患者通过选择性剖宫产分娩。未破裂病例经阴道分娩。6例服用抗惊厥药的患者中有2例发生了溶血性贫血，1例婴儿出生时伴有唇腭裂。接下来，我们回顾性调查了1978年1月至1995年3月在我院神经外科接受AVM随访的42名女性。46次妊娠中有3次并发脑出血。未破裂AVM的女性孕期出血率为每人每年0.065±0.036。孕妇出血率与育龄非孕妇出血率之间无显著差异，孕期AVM破裂风险未增加。
