• Users Online: 119
  • Print this page
  • Email this page
 
REVIEW ARTICLE
Ahead of Print

Anaesthetic challenges in complicated labour: Unruptured intracranial aneurysm


 Department of Anaesthesia, Dubai Hospital, Dubai, United Arab Emirates

Correspondence Address:
Ira Shrivastava,
Department of Anaesthesia, Dubai Hospital, Dubai
United Arab Emirates
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2227-2437.238566

Intracranial aneurysms are uncommon during pregnancy. Haemodynamic stress during pregnancy is a key factor in the multifactorial pathogenesis of cerebral aneurysm, contributing to the risk of aneurysm formation, progression and rupture. Successful management requires multidisciplinary care; anaesthetists require knowledge of obstetric anaesthesia, neuro-anaesthesia and critical care. The incidence of subarachnoid haemorrhage in pregnancy is 0.01%—0.05%, with a maternal mortality rate of 11% in treated cases and a foetal mortality rate of 5% in treated cases.[1] Definitive treatment involves either open neurosurgical clipping or endovascular therapy, maintaining stable transmural pressure in the aneurysm to prevent rupture. Very few cases have been reported in the literature, and guidelines for the management of intracranial aneurysm during pregnancy and evidence-based recommendations for obstetric anaesthesia in patients with unruptured intracranial aneurysm during labour do not exist. A review of the literature reveals varying results, differing on a case-by-case basis, for the treatment of intracranial aneurysms during pregnancy and labour. Reducing risks associated with intracranial aneurysm must focus on both mother and child. This review encourages the establishment of formal guidelines for an algorithmic approach to manage the intracranial aneurysm during pregnancy and labour.


Print this article
Search
 Back
 
  Search Pubmed for
 
    -  Shrivastava I
 Citation Manager
 Article Access Statistics
 Reader Comments
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed445    
    PDF Downloaded30    

Recommend this journal