Key result
Strict BP monitoring and low-dose aspirin facilitate uncomplicated vaginal delivery in Moyamoya disease.
Why the study?
Management strategies for pregnant women with Moyamoya disease after intracranial bypass grafting are not well established.
Case Report (n=1)
A pregnant patient with Moyamoya disease and prior STA-MCA bypass grafting was successfully managed with strict blood pressure monitoring and low-dose aspirin, resulting in an uncomplicated spontaneous vaginal delivery.
Hypothesis-generating for peripartum care in Moyamoya disease; should not yet inform practice guidelines.
Moyamoya disease (MD) is a chronic, progressive cerebrovascular disease distinguished by bilateral stenosis or occlusion of the arteries around the circle of Willis with resulting prominent arterial collateral circulation. We describe a pregnant woman in whom this diagnosis was confirmed by cerebral angiogram and treated with bilateral superficial temporal artery-middle cerebral artery (STA-MCA) bypass grafting prior to conception. The patient was managed with strict blood pressure monitoring and low-dose aspirin antepartum, intrapartum, and postpartum. The patient presented in spontaneous labor at term and underwent a spontaneous vaginal delivery without complications.
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Gimovsky et al. (2012) conducted a case report in Moyamoya disease (n=1). Strict blood pressure monitoring and low-dose aspirin was evaluated on Delivery outcome. Strict blood pressure monitoring and low-dose aspirin allowed a pregnant woman with Moyamoya disease and prior STA-MCA bypass grafting to undergo an uncomplicated spontaneous vaginal delivery.
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