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Ginecología y obstetricia de México
Print version ISSN 0300-9041
Abstract
HOYOS-GUERRERO,, Diana Marcela; ARAGON-MENDOZA, Rafael Leonardo; HERNANDEZ-RESTREPO, Michel and ALBA-ROMERO, Erika Andrea. Chiari malformation type I in pregnant women, case report. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.2, pp.133-139. Epub May 05, 2023. ISSN 0300-9041. https://doi.org/10.24245/gom.v91i2.7591.
BACKGROUND:
Chiari malformation is a rare congenital or acquired neurological disorder, characterized by the displacement of the rhombencephalic structures towards the spinal canal below the level of the foramen magnum; The frequency and progression that can occur during pregnancy are unknown, since there are changes during labor that can predispose to brainstem herniation with spinal cord compression; which poses a therapeutic challenge since there are no unified recommendations about the moment of delivery, delivery route and the best anesthetic technique in these patients
CLINICAL CASE:
A 24-year-old patient, G1P0 with a 34-week pregnancy, consulted the emergency room of the Hospital Universitario de la Samaritana, due to a clinical profile of headache with warning signs; to the study of cerebral magnetic resonance with a finding of Chiari type I malformation. In order to limit the Valsalva maneuvers during labor, a caesarean section was performed at term under neuraxial anesthesia without complications with a healthy newborn.
CONCLUSION:
Chiari malformation type I during pregnancy is rare. Patients diagnosed prior to pregnancy condition a follow-up in which the indication for neurosurgical treatment prior to conception is assessed. During pregnancy, no single method of termination or anaesthesia can be recommended and medical care should be provided by a multidisciplinary team formulating an individualized care plan to improve maternal and fetal outcome.
Keywords : Arnold-Chiari Malformation; Pregnancy; Treatment.