Ask the Experts - Is It Safe for My Patient to Become Pregnant After...
Ask the Experts - Is It Safe for My Patient to Become Pregnant After...
The patient is a 32-year-old woman, in whom I clipped a posterior communicating artery aneurysm. She achieved a full recovery with no deficit. No other aneurysms were found. She has no history of hypertension, diabetes, or smoking.
She wants to become pregnant. Are there any contraindications to her becoming pregnant, in relation to her history of aneurysm surgery?
Marco Gonzales-Berti, MD
Pregnancy is not contraindicated after aneurysm surgery, given this history.
However, there is the possibility of epileptic accidents during the pregnancy. If the patient underwent surgery after subarachnoid hemorrhage, the risk of epilepsy may increase, especially if she suffered cortical damage caused by vasospasm, the surgery itself, or ventricular drainage of cerebrospinal fluid. Furthermore, certain antiepileptic drugs are teratogenic; phenytoin, phenobarbital, sodium valproate, carbamazepine, oxcarbazepine, paramethadione, and trimethadione have been found to cause birth defects. Many of the newer antiepileptics have not been studied long enough to be recommend for use during pregnancy.
The patient is a 32-year-old woman, in whom I clipped a posterior communicating artery aneurysm. She achieved a full recovery with no deficit. No other aneurysms were found. She has no history of hypertension, diabetes, or smoking.
She wants to become pregnant. Are there any contraindications to her becoming pregnant, in relation to her history of aneurysm surgery?
Marco Gonzales-Berti, MD
Pregnancy is not contraindicated after aneurysm surgery, given this history.
However, there is the possibility of epileptic accidents during the pregnancy. If the patient underwent surgery after subarachnoid hemorrhage, the risk of epilepsy may increase, especially if she suffered cortical damage caused by vasospasm, the surgery itself, or ventricular drainage of cerebrospinal fluid. Furthermore, certain antiepileptic drugs are teratogenic; phenytoin, phenobarbital, sodium valproate, carbamazepine, oxcarbazepine, paramethadione, and trimethadione have been found to cause birth defects. Many of the newer antiepileptics have not been studied long enough to be recommend for use during pregnancy.
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