International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2014
Intracranial hemorrhage from moyamoya disease during pregnancy and puerperium.
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Liu Xing-Ju, Zhang Dong, Wang Shuo, Zhao Yuan-Li, Ye Xun, Rong Wang, Yong Cao, Kang Shuai, Zhao Ji-Zong
Аннотация
OBJECTIVE: To determine the incidence of hemorrhage among women with moyamoya disease (MMD) during pregnancy and puerperium.
METHODS: Data were assessed from patients with MMD who were referred to Beijing Tiantan Hospital between January 1985 and December 2012. Women aged 18-40 years with known parturient status were included. Annual hemorrhage rates were calculated as the ratio of number of bleeds to total number of patient-years of follow-up.
RESULTS: There were 184 patients with MMD. Ninety-six women were 18-40 years, and 81 had known parturient status. Among the 184 patients, 203 hemorrhages occurred during 5642 patient-years of follow-up. The annual hemorrhage rate was 3.6% overall, and 3.9% among 96 female patients (P>0.05). Among the 81 patients with known parturient status, 4 hemorrhages occurred during pregnancy and puerperium among 144 pregnancies (hemorrhage rate, 2.8% per pregnancy; 3.2% per year). Among the remaining 77 patients, 86 hemorrhages occurred during 2574 patient-years of follow-up (annual hemorrhage rate, 3.3%). The risk of hemorrhage from MMD was not increased during pregnancy and puerperium (hazard ratio, 0.73; 95% confidence interval, 0.23-2.35; P=0.60).
CONCLUSION: Pregnancy and puerperium are not risk factors for intracranial hemorrhage in hemorrhagic MMD. There is no need to advise patients against pregnancy.
METHODS: Data were assessed from patients with MMD who were referred to Beijing Tiantan Hospital between January 1985 and December 2012. Women aged 18-40 years with known parturient status were included. Annual hemorrhage rates were calculated as the ratio of number of bleeds to total number of patient-years of follow-up.
RESULTS: There were 184 patients with MMD. Ninety-six women were 18-40 years, and 81 had known parturient status. Among the 184 patients, 203 hemorrhages occurred during 5642 patient-years of follow-up. The annual hemorrhage rate was 3.6% overall, and 3.9% among 96 female patients (P>0.05). Among the 81 patients with known parturient status, 4 hemorrhages occurred during pregnancy and puerperium among 144 pregnancies (hemorrhage rate, 2.8% per pregnancy; 3.2% per year). Among the remaining 77 patients, 86 hemorrhages occurred during 2574 patient-years of follow-up (annual hemorrhage rate, 3.3%). The risk of hemorrhage from MMD was not increased during pregnancy and puerperium (hazard ratio, 0.73; 95% confidence interval, 0.23-2.35; P=0.60).
CONCLUSION: Pregnancy and puerperium are not risk factors for intracranial hemorrhage in hemorrhagic MMD. There is no need to advise patients against pregnancy.