Xing-Ju Liu1, Dong Zhang1, Shuo Wang1, Yuan-Li Zhao1, Xun Ye1, Wang Rong1, Cao Yong1, Shuai Kang1, Ji-Zong Zhao2. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: zhaojz205@gmail.com.
Abstract
OBJECTIVE: To determine the incidence of hemorrhage among women with moyamoya disease (MMD) during pregnancy and puerperium. METHODS: Data were assessed from patients with MMD who were referred to Beijing Tiantan Hospital between January 1985 and December 2012. Women aged 18-40 years with known parturient status were included. Annual hemorrhage rates were calculated as the ratio of number of bleeds to total number of patient-years of follow-up. RESULTS: There were 184 patients with MMD. Ninety-six women were 18-40 years, and 81 had known parturient status. Among the 184 patients, 203 hemorrhages occurred during 5642 patient-years of follow-up. The annual hemorrhage rate was 3.6% overall, and 3.9% among 96 female patients (P>0.05). Among the 81 patients with known parturient status, 4 hemorrhages occurred during pregnancy and puerperium among 144 pregnancies (hemorrhage rate, 2.8% per pregnancy; 3.2% per year). Among the remaining 77 patients, 86 hemorrhages occurred during 2574 patient-years of follow-up (annual hemorrhage rate, 3.3%). The risk of hemorrhage from MMD was not increased during pregnancy and puerperium (hazard ratio, 0.73; 95% confidence interval, 0.23-2.35; P=0.60). CONCLUSION: Pregnancy and puerperium are not risk factors for intracranial hemorrhage in hemorrhagic MMD. There is no need to advise patients against pregnancy. Crown
OBJECTIVE: To determine the incidence of hemorrhage among women with moyamoya disease (MMD) during pregnancy and puerperium. METHODS: Data were assessed from patients with MMD who were referred to Beijing Tiantan Hospital between January 1985 and December 2012. Women aged 18-40 years with known parturient status were included. Annual hemorrhage rates were calculated as the ratio of number of bleeds to total number of patient-years of follow-up. RESULTS: There were 184 patients with MMD. Ninety-six women were 18-40 years, and 81 had known parturient status. Among the 184 patients, 203 hemorrhages occurred during 5642 patient-years of follow-up. The annual hemorrhage rate was 3.6% overall, and 3.9% among 96 female patients (P>0.05). Among the 81 patients with known parturient status, 4 hemorrhages occurred during pregnancy and puerperium among 144 pregnancies (hemorrhage rate, 2.8% per pregnancy; 3.2% per year). Among the remaining 77 patients, 86 hemorrhages occurred during 2574 patient-years of follow-up (annual hemorrhage rate, 3.3%). The risk of hemorrhage from MMD was not increased during pregnancy and puerperium (hazard ratio, 0.73; 95% confidence interval, 0.23-2.35; P=0.60). CONCLUSION: Pregnancy and puerperium are not risk factors for intracranial hemorrhage in hemorrhagic MMD. There is no need to advise patients against pregnancy. Crown
Authors: Yun Ji Jung; Min-A Kim; Ja-Young Kwon; Hyo Ryun Lee; Hee Young Cho; Yong Won Park; Young Han Kim Journal: Yonsei Med J Date: 2015-05 Impact factor: 2.759