[Pregnancy and delivery in women with cerebrospinal fluid shunt due to hydrocephalus].
The aim of the study is following up the pregnancy and delivery in women with cerebrospinal fluid shunts for hydrocephalus.


METHODS
The study includes 12 pregnant women (9 nuliparous and 3 multiparous) ranging in age from 19 to 36 years which were initially shunted prior to the pregnancy. 9 of the patients had VP shunts and 3 with VA shunt. They were followed up for evolution of the pregnancy, the state of the shunts and the method of delivery.


RESULTS
It was found that the cerebrospinal fluid shunts does not affect the pregnancy outcome. Women with revision of the shunt during the pregnancy were not included in this study. We had 1 case of spontaneous abortion in 26 gestational week and two cases of preterm vaginal delivery. The other included in the study patients have live term births- 5 with vaginal delivery and 4 with caesarean sections. Spinal and epidural analgesia and general anesthesia was performed. Only in one case was performed revision and substitution of the shunt 6 weeks after the delivery due to obturation of the distal part of the shunt.


CONCLUSIONS
Presence of cerebral shunt does not affect essentially the pregnancy development. The vaginal delivery in women with cerebrospinal fluid shunts can be provide successfully with analgesic medicines that does not increase the intracranial pressure. The caesarean section should be performed by obstetrical indications and in cases with increased intracranial pressure.
Nikolov
A
A
Surchev
Zh
Zh
Nalbanski
B
B
Diavolov
V
V
Dimitrov
A
A
D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011256:Pregnancy Outcome