Clinical management of subarachnoid haemorrhage due to intracranial aneurysm in a pregnant woman in Quito, Ecuador: Case report
DOI:
https://doi.org/10.18597/rcog.3048Keywords:
Subarachnoid haemorrhage, pregnancy, platelet aggregation, intra-cranial arteriovenous malformations, aneurysmAbstract
Objective: To describe the diagnosis and management of a case of subarachnoid haemorrhage secondary to arterial cerebral aneurysm during the first half of gestation.
Materials and methods: A 26-year-old woman during a second pregnancy, with no prior miscarriages, and one previous cesarean section seen at a maternal and perinatal care referral centre located in Quito, Ecuador, with a diagnosis of subarachnoid haemorrhage at seventeen weeks of pregnancy. Cerebral pan-angiography showed a wide-neck cerebral aneurysm of the anterior temporal artery with bleeding.
Results: Treatment was performed using endovascular stenting and coiling. Later, the patient required dual anti-platelet therapy with clopidogrel and acetylsalicylic acid, maintained up to a week before delivery. Elective cesarean section was performed and the patient was delivered of a healthy baby at 37.2 weeks of gestation.
Conclusion: Endovascular treatment with the use of micro-coils, associated with anti-platelet aggregation therapy is an option to consider in pregnant women during the first half of gestation. Further clinical studies are needed in order to identify more fundamental therapeutic approaches for the management of these cases.Author Biographies
Andrés Felipe Mercado-González
Posgrado de Ginecología y Obstetricia, Universidad Central del Ecuador, Quito (Ecuador).
Walter Tarquino Moya-Pacheco
Posgrado de Ginecología y Obstetricia, Universidad Central del Ecuador, Quito (Ecuador).
Marco Vinicio Fornasini-Salvador
Centro de Investigación Biomédica (CENBIO), Universidad Tecnológica Equinoccial, Quito (Ecuador).
Gabriela Alexandra Peláez-Díaz
Centro de Investigación Biomédica (CENBIO), Universidad Tecnológica Equinoccial, Quito (Ecuador).
Manuel Eduardo Baldeón-Tixe
Centro de Investigación Biomédica (CENBIO), Universidad Tecnológica Equinoccial, Quito (Ecuador). manuel.baldeon@ute.edu.ec
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