Clinical review of 9 cases of pregnant women with Moyamoya disease.

Park, Sun Kyung; Hyun, Min Kyung; Cha, Kyung Hee; Shim, Jae Yoon; Won, Hye Sung; Lee, Pil Ryang; Kim, Ahm

Case Report

Korean Journal of Obstetrics & Gynecology 2009;52(11):1152-1158.
Published online November 1, 2009.

Clinical review of 9 cases of pregnant women with Moyamoya disease.

Sun Kyung Park, Min Kyung Hyun, Kyung Hee Cha, Jae Yoon Shim, Hye Sung Won, Pil Ryang Lee, Ahm Kim

Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. akim@amc.seoul.kr

Abstract

To describe the clinical manifestations and to establish the management of pregnancy and delivery in pregnant patients with Moyamoya disease. We identified nine women with Moyamoya disease. Six of these patients underwent cesarean section. General anesthesia was administered to only one patient, while epidural or combined spinal-epidural anesthesia was used for the others. The patient diagnosed during pregnancy was epidural anesthesia used for vaginal delivery and two patients diagnosed during post-delivery were delivered vaginally without anesthesia. Three patients showed pregnancy-related complications: intracranial hemorrhage, severe pre-eclampsia, and stroke. Five patients had term delivery, and four had pre-term delivery. The babies were healthy and had no complications. As blood pressure control is the most important factor for the pregnant women with Moyamoya disease, we recommend a spinal or epidural anesthesia in order to reduce the potential complications. Management of the patient's underlying disease is also crucial.

Key Words: Moyamoya disease, Pregnancy, Delivery