Korean J Obstet Gynecol.  2009 Nov;52(11):1152-1158.

Clinical review of 9 cases of pregnant women with Moyamoya disease

• Park SK
• Hyun MK
• Cha KH
• Shim JY
• Won HS
• Lee PR
• Kim A

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.

Keyword

Moyamoya disease; Pregnancy; Delivery

MeSH Terms

Anesthesia
Anesthesia, Epidural
Anesthesia, General
Blood Pressure
Cesarean Section
Female
Humans
Intracranial Hemorrhages
Moyamoya Disease
Pre-Eclampsia
Pregnancy
Pregnant Women
Stroke