Abstract
Many more women with shunted hydrocephalus are living into childbearing age due to advances in medical and surgical management. Limited data on maternal outcomes in this population leads physicians to rely on a handful of small studies and expert opinion when managing pregnant women with hydrocephalus. The literature was reviewed regarding maternal outcomes in women with hydrocephalus. Pregnancy is not contraindicated in women with shunted hydrocephalus. It is important to have baseline neuroimaging for these patients as more than half will experience headaches and 25–50% will require shunt revision in the peripartum period. The increased risk of shunt failure continues in the post-partum period for up to 1 year. It is unclear why there is an increased risk of shunt malfunction during pregnancy, but may be due to fluid shifts and increased abdominal pressure. Vaginal delivery is preferred in asymptomatic patients, especially in patients with ventriculoperitoneal shunts as they can become damaged or infected with surgical delivery. The type of anesthesia used and prophylactic antibiotic administration are active areas of discussion and often depend on patient factors and physician comfort. A multidisciplinary team of obstetricians, neurosurgeons, and anesthesiologists is beneficial for the multimodal care of pregnant women with hydrocephalus.
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Holste, K.G., Muraszko, K.M. (2023). Hydrocephalus and Pregnancy. In: Gupta, G., et al. Neurological Disorders in Pregnancy. Springer, Cham. https://doi.org/10.1007/978-3-031-36490-7_36
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DOI: https://doi.org/10.1007/978-3-031-36490-7_36
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