Of 37 patients in good condition after subarachnoid hemorrhage from a verified intracranial aneurysm that ruptured during pregnancy, 13 suffered a recurrent hemorrhage within three days to eight weeks, which caused eight maternal deaths. In 26 patients the aneurysms were surgically treated during the pregnancy: six by carotid occlusion and 20 by intracranial surgery, with two deaths, whereas eight of 11 patients treated only by bed rest died. Hypothermia was used during 12 craniotomies. Delivery was usually normal or aided by low forceps and block anesthesia. Cesarean section was performed on eight healthy mothers, and an emergency section on five moribund mothers. From four of the latter a healthy infant was delivered. It is concluded that ruptured aneurysms in pregnancy deserve prompt surgical treatment, as would be indicated if the patient were not pregnant.
Pool JL. Treatment of Intracranial Aneurysms During Pregnancy. JAMA. 1965;192(3):209–214. doi:10.1001/jama.1965.03080160029007
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