Subarachnoid hemorrhage secondary to ruptured cerebral aneurysm in pregnancy.

Eight patients suffering ruptured cerebral aneurysms during pregnancy were managed at the University of Western Ontario hospitals between 1967 and 1977. Seven aneurysms were managed surgically. All of these patients survived, 1 with permanent neurologic deficit. Seven living infants were delivered, 6 by vaginal delivery and 1 by cesarean section. One pregnancy was terminated surgically. One maternal death occurred in a patient whose aneurysm was inoperable. Fetal heart rates (FHR) were monitored by Doptone monitor during the aneurysm surgery. Clipping of the aneurysms was performed under induced hypotension. The prognosis for ruptured cerebral aneurysms during pregnancy is good for both mother and fetus. A short course of conservative therapy followed by surgical management of the aneurysm is advocated. Delivery may be managed according to obstetrical indications following surgical correction of the aneurysm.