Managing pregnancy in women with ventriculoperitoneal shunt: a review of the literature
Keywords:caesarean section, spinal anesthesia, vaginal delivery, ventriculoperitoneal shunt
The ventriculoperitoneal (VP) shunt is an effective and mainstay treatment for hydrocephalus and since its introduction in 1971, the number of hydrocephalus patients reaching reproductive age has increased. There are still doubts about management of these pregnancies, especially when it’s about mode of delivery. The article aims to provide an overview of the current issues associated with the management of the patients with VP shunt. The emphasis is on proper care of these patients including multidisciplinary management throughout pregnancy, delivery and maternity, as well as on intensive medical consultation when planning pregnancy. Evaluation by both neurosurgeons and obstetricians, along with MRI images, should be performed before pregnancy. Vaginal delivery with, if needed, shortened second stage of labor is preferred in women without absolute neurosurgical indication, acute neurologic condition or concrete obstetrical indication. In cases of obstetrical indications and with symptoms of increased intracranial pressure, the caesarean section is required.
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