Publication:

Conservative management of cerebral arteriovenous malformations in pregnancy

We report two cases of pregnant women diagnosed with unruptured cerebral arteriovenous malformations (AVM), each with distinct clinical presentations. One had history of focal seizures since adolescence. The other woman had history of an unevaluated focal neurological deficit prior to conception. During pregnancy, assessment with neuroimaging revealed an unruptured AVM. In both cases, a multidisciplinary team involving obstetricians, neurologists, neurosurgeons, and anesthesiologists was engaged to formulate the management plan. Considering the stability of the patients, conservative management was chosen and the pregnancy was closely monitored. The patient remained neurologically stable throughout gestation. Delivery planning aimed to minimize maternal hemodynamic stress and the risk of AVM rupture. Both cases underwent Caesarean delivery delivery in controlled conditions. There were no intraoperative, postpartum or neonatal complications.