Neurológia pre prax 4/2016

Management of hydrocephalus in patients with an implanted shunt for hydrocephalus during pregnancy and delivery

ecause of treatment advances in hydrocephalus the number of patients reaching reproductive age and intending to become pregnant has increased in recent years. Numerous changes occur during pregnancy and these changes contribute to increased incidence of complications during pregnancy and childbirth. Therefore, it is necessary to make a preconception exam and specify pregnancy management, a suitable method of childbirth and dealing with potential complications. Possible shunt malfunction is necessary to diagnose properly and in time and solve it individually, taking into account the overall and neurological status of the patient and gestational age. Vaginal delivery is considered by most authors as the first option. Primary cesarean section is preffered in patients with obstructive hydrocephalus or rapid deterioration in the case of shunt malfunction. Epidural anesthesia or general, eventually spinal anesthesia are recommended.

Keywords: hydrocephalus, shunt, ventriculoperitoneal shunt, ventriculoatrial shunt, pregnancy