Pregnancy and extracranial shunts: case report and review of the literature.

This case involves a 32-year-old pregnant patient with a preexisting ventriculoperitoneal shunt. At term, she had a vaginal delivery with vacuum assistance, an epidural, and prophylactic antibiotics. Although there are no controlled studies validating the best course of management in such cases, there seems to be agreement that vaginal delivery can be attempted in the absence of other obstetrical indications for operative delivery. Obstruction of the shunt and, less commonly, abdominal cysts related to the distal end of the shunt are the principal obstetrical complications associated with a cerebrospinal shunt.