gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

AVM haemorrhage in pregnant patients – use of multicentre databases for the quantitative assessment of rare diseases and treatment guidelines

AVM-Blutung bei schwangeren Patienten – Nutzen multizentrischer Datenbanken zur quantitativen Bewertung seltener Krankheiten und Behandlungsrichtlinien

Meeting Abstract

  • presenting/speaker Nazife Dinc - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland
  • Johanna Quick-Weller - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland
  • Michael Eibach - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland
  • Gerhard Marquardt - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland
  • Jürgen Konczalla - Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP002

doi: 10.3205/19dgnc341, urn:nbn:de:0183-19dgnc3411

Published: May 8, 2019

© 2019 Dinc et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Treatment of pregnant patients with AVM hemorrhage is challenging. However, data is also scarce. Because of the the rarity of this disease, standardized modalities in imaging and treatment algorithm are necessary in order to make individual treatment plans. The aim of the present study is to highlight the need for centralized databases to standardize treatment progression.

Methods: A retrospective study was performed in 79 female patients with ruptured AVMs, who were admitted to our neurosurgical department between 2002 and 2018. Only pregnant patients, who had an AVM hemorrhage during pregnancy were evaluated. We reviewed primary admission state (based on World Federation of Neurosurgical Societies: WFNS), AVM features, diagnostic and treatment algorithms and the final outcome at the last follow up.

Results: Three (3.8%) pregnant patients, who had an AVM hemorrhage before or during pregnancy were found. Mean age was 30 years. At onset, two patients (66.7%) had a WFNS grade III, and a Spetzler Martin Grade 4 AVM. One patient suffered an AVM hemorrhage in the 33+5 week of gestation and underwent an emergency cesarean section. Postpartum management was microsurgical hemorrhage evacuation and AVM resection with a favorable outcome.

Conclusion: AVM hemorrhage during pregnancy is rare and carries a high risk for the patient and the fetus. Treatment of pregnant patients with AVM hemorrhage is recommended in vascular neurosurgical departments. Central multicenter databases – e.g. built up and hosted by the DGNC and/or the vascular section - are useful for optimizing and standardizing the course of treatment. They can provide valid information for better treatment choices.