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Cerebral Aneurysms in Pregnancy and Delivery: Pregnancy and Delivery Do Not Increase the Risk of Aneurysm Rupture.
MedLine Citation:
PMID:  23147786     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: It is not known what effect pregnancy or delivery has on the risk of rupture of an intracranial aneurysm, and consequently, the optimal management of unruptured aneurysms in pregnancy is unclear. OBJECTIVE:: To study the effect of pregnancy and delivery on the risk of rupture of intracranial aneurysms and to delineate trends in neurosurgical and obstetric management of pregnant women with intracranial aneurysms. METHODS:: The Nationwide Inpatient Sample (NIS) data were analyzed for years 1988-2009 to estimate the risk of aneurysm rupture during pregnancies and deliveries. We calculated the risk by dividing the observed number of patients with ruptured aneurysm during pregnancy and delivery by the expected number based on the incidence among women of pregnancy age. RESULTS:: There were 714 and 172 hospitalizations involving ruptured aneurysms with pregnancy and delivery, respectively. Assuming 1.8% prevalence of unruptured aneurysms among all women of pregnancy age, we estimated 48,873 women hospitalized for pregnancy and 312,128 women hospitalized for delivery had unruptured aneurysms. The risks of rupture during pregnancy and deliveries were 1.4% (95% CI=[1.35,1.57]) and 0.05% (95% CI=[0.0468, 0.0634]), respectively. Of 218 deliveries performed with unruptured aneurysm, 153 were cesarean deliveries (70.18%, 95% CI=[64.06, 76.30%]), suggesting that the rate of cesarean deliveries in patients with unruptured aneurysms is significantly higher than in the general population (p<.001). CONCLUSION:: We were not able to find an increased association between pregnancy or delivery and the risk of rupture of cerebral aneurysms. The significantly higher rate of cesarean deliveries performed in patients with unruptured aneurysms may not be necessary.
Authors:
Young Woo Kim; Dan Neal; Brian L Hoh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-26
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 2Department of Biostatistics, University of Florida, Gainesville, Florida, USA 3Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
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