妊娠期出血性脑血管病手术治疗后继续妊娠的安全性

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Abstract Objective To explore the safety of ongoing pregnancy after multidisciplinary management of hemorrhagic encephalopathy. Methods Six pregnant patients with hemorrhagic encephalopathy admitted to Beijing Tiantan Hospital between January 2013 and August 2016 were enrolled into this study, all of whom were diagnosed by multiple departments and treated by the Department of Neurosurgery. The postoperative obstetrics materials for ongoing pregnancy were analyzed. Consistent fetus monitoring was performed during operation. Results After 24-48 h at the ICU, the patients were transferred back to the obstetric wards and supervised in terms of their ongoing pregnancy. One case of midbrain aneurysm, one case of aneurysm with arteriovenous malformation, two cases of arteriovenous malformation, and two cases of spontaneous hemorrhagic cerebrovascular disease were treated with such approaches as aneurysmectomy, arteriovenous malformationectomy, crainiotomy, and intracranial hematoma drainage. The surgical sites included one left cerebellum, one right cerebellum, one occipital part of cerebrum, one right frontal lobe, one right posterior occipital lobe, one anterior artery and left middle cerebral artery. The size of the hematomas ranged from 3 to 5 cm, while onset gestational weeks ranged from 18 to 27 weeks. Five of the six pregnancies were singletons, and one was a twin, all of whom were full-term with birth weights ranging from 2320 to 3400 g. One fetus underwent preoperative and postoperative cerebrovascular radiation, and the total radiation dosage was 1.18 Rad. Conclusions Intraoperative anesthesia should be based on the patient’s condition. Radiation exposure should be limited. Hemodynamic stabilization and blood oxygen saturation should be maintained during operation. Postoperative multidisciplinary evaluation and treatment are needed so that the patient can continue pregnancy to full term.

Key words： gestational hemorrhagic encephalopathy surgical treatment ongoing pregnancy

Received: 10 October 2019

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	Articles by authors
	HAN Dan
	GAO Wanli
	LIANG Zhuwei
	WANG Shuo
	ZHAO Jizhong
	MENG Shihui
	LI Yanrong

Cite this article:

HAN Dan,GAO Wanli,LIANG Zhuwei等. Safety of ongoing pregnancy after multidisciplinary surgical management of hemorrhagic cerebrovascular disease[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2020, 31(2): 107-109.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2020/V31/I2/107

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