title: Pregnancy outcomes in women with moyamoya disease: experiences at a single center in Korea.
abstract: OBJECTIVE
  Moyamoya disease (MMD) occurs predominantly in Korean and Japanese women. The aim of this study was to investigate clinical features and pregnancy outcomes in women with MMD.
  
  
  METHODS
  We conducted a retrospective chart review of women with MMD who visited our Department of Obstetrics and Gynecology between January 2005 and October 2013. For all study subjects, clinical features, demographic characteristics, and perinatal outcomes were recorded.
  
  
  RESULTS
  We identified 28 pregnancies in 22 patients who had been diagnosed with MMD. The mean maternal age at delivery was 31.9±3.5 years old. The mean gestational age at delivery was 38.0±0.9 weeks. Among the 28 pregnancies, 25 (92.5%) underwent cesarean section; 19 (76.0%) of them were performed under regional anesthesia and six (24.0%) under general anesthesia. The mean newborn weight was 3233.7±348.2 g. The 5-minute Apgar score in 85% of the newborns was higher than 8, with no other apparent complications. During the puerperal period, transient ischemic attack symptom or seizure occurred in 4 cases, although patients recovered within a few days.
  
  
  CONCLUSIONS
  For pregnant women with MMD, it is important to control blood pressure and prevent hyperventilation during the intrapartum period, and the best methods of delivery and anesthesia should be considered to avoid unfavorable sequelae. Additionally, a multidisciplinary approach (i.e., neurosurgery) is necessary to constantly manage underlying diseases.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yun Ji
authors.initials: YJ
authors.lastname: Jung
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Min-A
authors.initials: MA
authors.lastname: Kim
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Kwon
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyo Ryun
authors.initials: HR
authors.lastname: Lee
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Cho
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Won
authors.initials: YW
authors.lastname: Park
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Severance Hospital, Institute of Women's Medical Life Science, Yonsei University College of Medicine, Seoul, Korea. YHKIM522@yuhs.ac.
authors.forename: Young Han
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D009072:Moyamoya Disease / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Moyamoya disease; outcome; pregnancy
references.citation: J Clin Neurosci. 2004 Jun;11(5):525-7
references.pmid: 15177400
references.citation: Int J Gynaecol Obstet. 2014 May;125(2):150-3
references.pmid: 24552854
references.citation: Stroke. 1997 Dec;28(12):2513-7
references.pmid: 9412642
references.citation: Neurosurgery. 1998 Aug;43(2):360-8; discussion 368-9
references.pmid: 9696092
references.citation: Acta Neurochir (Wien). 2006 Jun;148(6):685-9; discussion 689
references.pmid: 16505969
references.citation: J Obstet Gynaecol. 2008 Apr;28(3):345-6
references.pmid: 18569487
references.citation: Aust N Z J Obstet Gynaecol. 2008 Dec;48(6):608-9
references.pmid: 19133054
references.citation: N Engl J Med. 2009 Mar 19;360(12):1226-37
references.pmid: 19297575
references.citation: J Obstet Gynaecol Res. 2009 Aug;35(4):787-9
references.pmid: 19751343
references.citation: J Obstet Gynaecol Res. 2009 Oct;35(5):974-7
references.pmid: 20149050
references.citation: Neurol Med Chir (Tokyo). 2012;52(5):304-10
references.pmid: 22688067
references.citation: J Clin Neurosci. 2012 Oct;19(10):1358-62
references.pmid: 22917762
references.citation: Neurol Med Chir (Tokyo). 2013;53(8):561-4
references.pmid: 23979053
references.citation: Stroke. 2014 Apr;45(4):1090-5
references.pmid: 24595588
references.citation: Neurol Med Chir (Tokyo). 1992 Nov;32(12):883-6
references.pmid: 1282678