[Clinical study on the intracranial arteriovenous malformation associated with pregnancy]

We studied twelve pregnancies in nine patients with arteriovenous malformation (AVM) managed at our hospital from January, 1984 to March, 1993. Three of the cases were diagnosed as subarachnoidal hemorrhage (SAH) and one as epilepsy during pregnancy. The AVM was resected surgically in two ruptured cases during pregnancy, and the fetus was delivered vaginally. In the other case of ruptured AVM delivery was by elective cesarean section. In the non-ruptured case delivery was vaginal. Two of the six patients who took an anticonvulsant developed hemolytic anemia, and one baby was born with a cleft lip and palete. We next retrospectively investigated 42 women who were followed up for AVM at the department of neurosurgery in our hospital from January, 1978 to March, 1995. Three pregnancies of a total of 46 pregnancies were complicated by a cerebral hemorrhage. The hemorrhage rate during pregnancy for women with unruptured AVM was 0.065 +/- 0.036 per person per year. There was no significant difference between the hemorrhage rate for pregnant women and that for nonpregnant women of childbearing age, and the risk for rupture of AVM was not increased in pregnancy.