Abstract
Although uncommon, aneurysmal subarachnoid haemorrhage (SAH) in pregnancy can be devastating
for both mother and baby. It is the leading cause of other indirect maternal death
in England and Wales accounting for 60 deaths in the decade 1988–1999. No single obstetric
or neurosurgical unit has sufficiently large database or experience in managing this
condition in pregnancy. With significant improvements in antenatal care and management
of deliveries, non-obstetric causes of maternal death such as aneurysmal subarachnoid
haemorrhage are likely to become increasingly significant. The clinical features of
aneurysmal subarachnoid haemorrhage closely resemble those of other commoner conditions
seen in pregnancy. It is therefore imperative that awareness by obstetricians and
other frontline staff is increased so that a high index of suspicion is maintained
when pregnant women present with unique headaches. Prompt neurosurgical referral is
vital and early involvement of an experienced neuroradiologist essential. It is only
when an early diagnosis is made and an aggressive treatment instituted that the bleak
case-fatality figure associated with aneurysmal subarachnoid haemorrhage in pregnancy
can be improved.
This review, by a multidisciplinary and multicenter team, provides a comprehensive
update on the epidemiology, aetiology, clinical presentation, diagnosis and the complexities
of the multidisciplinary management of this serious and potentially fatal condition
when it occurs in pregnancy.
Keywords
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Article info
Publication history
Accepted:
April 5,
2004
Received in revised form:
February 23,
2004
Received:
December 7,
2003
Identification
Copyright
© 2004 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
