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Titolo:
Hydrocephalus and the reproductive health of women: The medical implications of maternal shunt dependency in 70 women and 138 pregnancies
Autore:
Liakos, AM; Bradley, NK; Magram, C; Muszynski, C;
Indirizzi:
Hydrocephalus Res Fdn, Atlanta, GA USA Hydrocephalus Res Fdn Atlanta GA USA rocephalus Res Fdn, Atlanta, GA USA
Titolo Testata:
NEUROLOGICAL RESEARCH
fascicolo: 1, volume: 22, anno: 2000,
pagine: 69 - 88
SICI:
0161-6412(200001)22:1<69:HATRHO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENTRICULOPERITONEAL SHUNT; NEUROSURGICAL SHUNTS; MALFUNCTION; MANAGEMENT;
Keywords:
hydrocephalus; maternal; obstetric; pregnancy; prognosis; revision; shunt;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Liakos, AM Hydrocephalus Res Fdn Inc, 1670 Green Oaks Circle, Lawrenceville, GA 30043USA Hydrocephalus Res Fdn Inc 1670 Green Oaks Circle Lawrenceville GA USA 30043
Citazione:
A.M. Liakos et al., "Hydrocephalus and the reproductive health of women: The medical implications of maternal shunt dependency in 70 women and 138 pregnancies", NEUROL RES, 22(1), 2000, pp. 69-88

Abstract

An increasing number of women with cerebrospinal fluid shunts are surviving to child-bearing age, and are making independent decisions in regard to planning their families. As a result, a broad range of interdisciplinary health care professionals will require information about the management of these patients, especially during pregnancy and delivery. The purpose of this ongoing study is to gather comprehensive data from shunted women regarding their clinical history during pregnancy and within the six-month post-partum period. As part of this study, the following questions were addressed: 1. How does maternal shunt dependency influence the course of pregnancy and pregnancy outcomes? 2. What neurosurgical complications characterize this population of patients! 3. What complications of shunt dependency influence obstetrical management including pre-natal testing and delivery? 4. What arethe implications of shunt dependency with respect to general reproductive health concerns within this population! A total of 70 respondents, 18-41 years old and accounting for 138 pregnancies, completed a questionnaire providing information on maternal background, medical history, shunt performanceduring pregnancy, management of delivery, pregnancy outcomes, and unusual complications. One hundred three (103) pregnancies resulted in 105 live births including two surviving sets of twins. of these, 84 occurred in women with ventriculoperitoneal shunts (including both mothers who gave bi;th to live twins). Four women underwent therapeutic abortions, five delivered pre-term, one mother delivered a stillborn infant, and 16 experienced 32 miscarriages (including two ectopic pregnancies, and 33 fetal losses). Three women had seizures during pregnancy. Nine mothers reported an increase in headache activity during pregnancy. Twelve described abdominal pains during the course of pregnancy with anecdotal reports of increased frequency of painful episodes during the first and third trimesters. Twelve babies were diagnosed with congenital defects, including one pair of fraternal twins individually diagnosed with symmetric parietal foramina. Seven additional children were diagnosed with developmental disabilities including attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), pervasive developmental delay (PDD), and autism. Shunt malfunctions and revisions occurred seven times (four women) during pregnancy, and in 24 pregnancies (13 women) within six months of delivery. One malfunction and revision followedthe miscarriage of twins at 12 gestational weeks. No acute malfunctions requiring immediate revision occurred during delivery, although two women reported severe headaches during labor. Transient signs of raised intracranialpressure occurred in 15 mothers over the course of 19 pregnancies which did not require surgical revision of the shunt following delivery or termination of pregnancy. No signs of shunt malfunction were identified in 100 of the pregnancies described in this series; 3 1 of these resulting in miscarriage and 69 resulting in live births. This study extends observations made previously to a larger population of shunt dependent mothers, and nearly doubles the amount of data available in our last publication. The results suggest that maternal shunt dependency carries a relatively high incidence of complications for some patients, but that proper management of these patients can lead to normal pregnancy and delivery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/03/20 alle ore 10:30:00