Neurosurgical procedures in pregnancy

PURPOSE: Over the past few decades maternal mortality has progressively declined because of improved management of the major obstetric problems of hemorrhage, infection, and toxemia. As a result, the relative incidence of deaths resulting from non obstetric causes has increased. Chief among nonobstetric causes are neurologic disorders. Those most common during pregnancy are low back pain, intracranial tumors, subarachnoid hemorrhage, and neurotrauma. The management of the neurosurgical pathologies during pregnancy needs some specifications for both the mother and the fetus. METHODS: We performed a retrospective study evaluating the clinical, radiological, and surgical characteristics of 9 patients who have cranial neuropathologies and have undergone neurosurgical intervention. RESULTS: Most of the patients in this study had vaginal delivery. Prominent neurosurgical disease related to cerebral damage. Every patient underwent a laboratory and radiological evaluation. All except one survived the neurosurgical pathology. Neither baby nor mother had significant problem during delivery and neurosurgical intervention. CONCLUSION: Pregnant women may face to every kind of neurosurgical pathology that nonpregnant women have faced. In addition, pregnancy itself, gives rise some metabolic changes in the women and those changes may cause some neurologic pathologies to be symptomatic or to aggravate the present symptomatology. Because of those reasons, close neurologic follow up of a pregnant woman is of vital importance. At the end of a pregnancy having experienced some neurologic interventions including diagnostic evaluation or surgical intervention does not necessitates the cesarean section for a neurologically intact infant and mother. OBJETIVO: Nas últimas décadas a mortalidade maternal tem declinado progressivamente devido ao melhor controle dos grandes problemas obstétricos tais como a hemorragia, infecção e toxemia. Em contrapartida a incidência de óbitos resultantes de causas não obstétricas tem aumentado, sobretudo as resultantes de doenças neurológicas. As causas mais comuns, durante a gravidez, são tumores intracraneanos, hemorragia subaracnóidea e trauma neurológico. O controle de doenças neurocirúrgicas durante a gravidez necessita de cuidados especiais para a mãe e o feto. MÉTODOS: Realizou-se estudo retrospectivo avaliando as características clínicas, radiológicas e cirúrgicas de nove pacientes que tiveram doenças que exigiram intervenção neurocirúrgica.