Yuki Higashi, Hideaki Ohmatsu, Shino Nehashi, Risa Hasegawa, Suguru Yoshizaki and Takeshi Numai(2007). Anesthesia for a Pregnant Patient with a Ruptured Cerebral Arteriovenous Malformation. J. of SJWS 8: 33-36

Abstract: A 31 year old woman suffered sudden hemiplegia and headache during the 17th week of her pregnancy. Her diagnosis was cerebral arteriovenous malformation, ruptured in left putamen and into lateral ventricle. Her neurosurgical operation was performed in the 19th week of her pregnancy. Anesthesia was induced using propofol and vecuronium, and maintained with sevoflurane (0.5-1.0%) and nitrous oxide (<50%) in oxygen. During surgery, fetal heart rate was monitored continuously.
Intense hypotension was not chosen because it may have placed the fetus at risk of intrauterine asphyxia. Ventilation was controlled to maintain PaCO2 between 27 and 35mmHg. Her neurological symptom improved and her baby was delivered vaginally in the 40th gestational week.

Key words: arteriovenous malformation (AVM), intracranial hemorrhage, pregnancy, anesthesia