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Pregnancy and Vaginal Delivery in Epidural Analgesia in Woman with Cerebrospinal Fluid Shunt
Danijel Buršac
; University of Zagreb, University Hospital »Merkur«, Clinical Department of Obstetrics and Gynecology, Zagreb, Croatia
Jasminka Peršec
; University of Zagreb, University Hospital Dubrava, Clinical Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Zagreb, Croatia
Zoran Peršec
; University of Zagreb, University Hospital Dubrava, Department of Urology, Zagreb, Croatia
Željko Duić
; University of Zagreb, University Hospital »Merkur«, Clinical Department of Obstetrics and Gynecology, Zagreb, Croatia
Jasenka Zmijanac Partl
; University of Zagreb, University Hospital »Merkur«, Clinical Department of Obstetrics and Gynecology, Zagreb, Croatia
Željko Glavić
; General Hospital Po`ega, Department of Surgery, Požega, Croatia
Zlatko Hrgović
; General Hospital Offenbach, Department of Obstetrics and Gynecology, Offenbach am Main, Germany
Katarina Bojanić
; University of Zagreb, University Hospital »Merkur«, Department of Neonatology, Zagreb, Croatia
Abstract
Hydrocephalus is a medical condition characterized by enlargement of cerebral ventricles due to abnormal cerebro- spinal fluid accumulation. Hydrocephalic women with cerebrospinal fluid (CSF) shunts are now surviving to reproduc- tive age, but still there are doubts regarding the mode of delivery, analgesia and anesthesia. Postpartal complications are more frequently described in deliveries ended by cesarean section than in spontaneous vaginal deliveries. We present a case of labor in the 32-year old woman, with congenital hydrocephalus and a preexisting ventriculoperitoneal (VP) shunt. After thorough review of current literature, we came to conclusion that without absolute neurosurgical indication or acute development of listed symptoms (headaches, irritability, light sensitivity, hyperesthesia nausea, vomiting, ver- tigo, migraines, seizures, weakness in the arms or legs, strabismus and double vision) the best way to finish the preg- nancy of woman with VP shunt is spontaneous vaginal delivery with the use of epidural analgesia, mediolateral episiotomy and vacuum extraction.
Keywords
regional anesthesia; vaginal delivery; ventriculoperitoneal shunt; cesarean section
Hrčak ID:
118396
URI
Publication date:
30.12.2013.
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