European journal of obstetrics, gynecology, and reproductive biology · 2014
Impact of maternal brain tumours on perinatal and maternal management and outcome: a single referral centre retrospective study.
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Girault Aude, Dommergues Marc, Nizard Jacky
Аннотация
OBJECTIVE: To evaluate the impact of maternal brain tumours on perinatal and maternal management and outcome.
STUDY DESIGN: We performed a retrospective cohort study in a single referral centre with departments of obstetrics, neurology, and neurosurgery from January 2003 to July 2011. Cases were retrieved from our hospital databases, excluding pituitary adenomas, metastasis, and vascular tumours. Postnatal follow-up was of at least 6 months. Studied parameters were tumour type, gestational age at diagnosis if applicable, neurological events, obstetrical complications, pregnancy outcome, mode of delivery, peripartum analgesia, need for specific treatments, and maternal morbidity and mortality.
RESULTS: 20 women (23 pregnancies) diagnosed with a brain tumour. Overall, there were 4 terminations of pregnancy, 4 elective premature caesarean deliveries, 15 live births ≥37 WG (9 caesarean and 6 vaginal deliveries), and 4 maternal deaths within 6 months postpartum. The brain tumour was diagnosed during pregnancy in 7 cases (group A), before pregnancy with preconception counselling in 10 (group B), and before pregnancy without preconception counselling in 6 (group C). In group A, there were 1 termination of pregnancy (TOP), 3 preterm elective caesarean deliveries, 3 live births ≥37 WG with one vaginal delivery, and 2 maternal deaths. In group B, there were 1 elective premature caesarean delivery and 7 live births ≥37 WG with 4 vaginal deliveries. In group C, there were 3 TOP, 3 live births ≥37 WG with one vaginal delivery, and 2 maternal deaths.
CONCLUSIONS: Poor perinatal outcome and maternal death were associated with unplanned pregnancies and tumours diagnosed during pregnancy. Vaginal birth with epidural analgesia was nevertheless observed in all groups.
STUDY DESIGN: We performed a retrospective cohort study in a single referral centre with departments of obstetrics, neurology, and neurosurgery from January 2003 to July 2011. Cases were retrieved from our hospital databases, excluding pituitary adenomas, metastasis, and vascular tumours. Postnatal follow-up was of at least 6 months. Studied parameters were tumour type, gestational age at diagnosis if applicable, neurological events, obstetrical complications, pregnancy outcome, mode of delivery, peripartum analgesia, need for specific treatments, and maternal morbidity and mortality.
RESULTS: 20 women (23 pregnancies) diagnosed with a brain tumour. Overall, there were 4 terminations of pregnancy, 4 elective premature caesarean deliveries, 15 live births ≥37 WG (9 caesarean and 6 vaginal deliveries), and 4 maternal deaths within 6 months postpartum. The brain tumour was diagnosed during pregnancy in 7 cases (group A), before pregnancy with preconception counselling in 10 (group B), and before pregnancy without preconception counselling in 6 (group C). In group A, there were 1 termination of pregnancy (TOP), 3 preterm elective caesarean deliveries, 3 live births ≥37 WG with one vaginal delivery, and 2 maternal deaths. In group B, there were 1 elective premature caesarean delivery and 7 live births ≥37 WG with 4 vaginal deliveries. In group C, there were 3 TOP, 3 live births ≥37 WG with one vaginal delivery, and 2 maternal deaths.
CONCLUSIONS: Poor perinatal outcome and maternal death were associated with unplanned pregnancies and tumours diagnosed during pregnancy. Vaginal birth with epidural analgesia was nevertheless observed in all groups.