title: Maternal neurosurgical shunts and pregnancy outcome.
abstract: OBJECTIVE
  To assess pregnancy outcome in women with ventriculoperitoneal or lumboperitoneal shunts.
  
  
  METHODS
  Charts were reviewed retrospectively for mothers with ventriculoperitoneal or lumboperitoneal shunts delivered at Hutzel Hospital from 1976-1992. Patients were identified by cross-referencing medical records from Children's Hospital Neurosurgical Division and medical records at Hutzel Hospital during this period.
  
  
  RESULTS
  Eight patients with 25 pregnancies were identified from 1976-1992. Indications for shunt placement were pseudotumor cerebri (four with lumboperitoneal shunts) and congenital hydrocephalus (four with ventriculoperitoneal shunts). Pregnancy outcomes were two elective abortions, five spontaneous abortions, two preterm vaginal deliveries, one mid-forceps rotation, two primary low transverse cesareans, two repeat low transverse cesareans, and 11 spontaneous vaginal deliveries. No patient received prophylactic antibiotics during labor and vaginal delivery because of the shunt. There were no shunt-related complications.
  
  
  CONCLUSIONS
  This series doubles the number of previously reported pregnancy outcomes in women with neurosurgical shunts. Contrary to the literature suggesting cesarean delivery and prophylactic antibiotics for all patients, our experience suggests that vaginal delivery can be considered and that prophylactic antibiotics are not an absolute necessity in uncomplicated vaginal deliveries.
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI.
authors.forename: J B
authors.initials: JB
authors.lastname: Landwehr
authors.forename: N B
authors.initials: NB
authors.lastname: Isada
authors.forename: P G
authors.initials: PG
authors.lastname: Pryde
authors.forename: M P
authors.initials: MP
authors.lastname: Johnson
authors.forename: M I
authors.initials: MI
authors.lastname: Evans
authors.forename: A I
authors.initials: AI
authors.lastname: Canady
mesh_terms: D000293:Adolescent; D000328:Adult; D002557:Cerebrospinal Fluid Shunts; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies