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      Subarachnoid hemorrhage from intracranial aneurysms during pregnancy and the puerperium.

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          Abstract

          Subarachnoid hemorrhage (SAH) due to the rupture of an intracranial aneurysm (IA) is a rare but serious complication of pregnancy and is responsible for important morbidity and mortality during pregnancy. This study reviewed reports of ruptured IA during pregnancy and the puerperium, and our own cases of ruptured IA in pregnant women. Hemorrhage occurred predominantly during the third trimester of pregnancy, when maternal cardiac output and blood volume increase and reach maximum. Physiological and hormonal changes in pregnancy are likely to affect the risk of IA rupture. Ruptured IAs during pregnancy should be managed based on neurosurgical considerations, and the obstetrical management of women with ruptured IAs should be decided according to the severity of SAH and the gestational age. Emergent cesarean section followed by clipping or coiling of aneurysms is indicated if the maternal condition and the gestational age allow such interventions. Although SAH during pregnancy can result in disastrous outcomes, the necessity of intracranial screening for high-risk pregnant women is still controversial.

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          Author and article information

          Journal
          Neurol Med Chir (Tokyo)
          Neurologia medico-chirurgica
          Japan Neurosurgical Society
          1349-8029
          0470-8105
          2013
          : 53
          : 8
          Affiliations
          [1 ] Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. hkataoka@ncvc.go.jp
          Article
          DN/JST.JSTAGE/nmc/53.549
          10.2176/nmc.53.549
          23979051
          5bf77b5e-a9b4-4c6c-8a71-c30f5e7d22e0
          History

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