小児期発症もやもや病における妊娠・出産をめぐる諸問題について

概要

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We report 32 female patients in whom moyamoya disease was diagnosed when they were younger than 14 years old. Of these, 29 patients underwent bypass surgery during childhood. Two patients became pregnant at the age of 21 and 22, respectively. Careful follow-up was performed to avoid toxemia, hypertension and excessive increase in body weight. MR angiography revealed welldeveloped collateral flow through the operated extracranial carotid artery system and no moyamoya vessels. Blood flow study, performed prior to pregnancy in 1 case, showed preserved blood flow and reactivity to acetazolamide. Delivery was uneventfully performed through Cesarean section under general anesthesia at full term. Three other patients underwent bypass surgery when they were older than 20 years old. Of these, 1 became pregnant and uneventfully had a normal delivery. We discuss the clinical problems in managing pregnant patients known to have moyamoya disease prior to pregnancy, suggesting strategies for these patients.
日本脳卒中の外科学会の論文
2001-07-31