Aneurysm and pregnancy

[Lillie75]

I am pregnant and have a brain aneurysm that was coiled several years ago and have had no problems since.

I am wondering if anyone has been through this and considered the pros/cons of vaginal birth vs c-section?

There doesn't seem to be very much information on whether vaginal delivery carries a risk of rupture or dislodgment of the coils and my consultant hasn't given me a view either way.

Thanks

[chloeb2002]

id suspect they should monitor you bp quite closely throughout the preganacy / labour and an increase in bp can affect your inter cranial pressure. Im unsure about labour although maybe an elscs would be a safer option than suck it an see? I have seen one person who suffered a large cerebral haemorage after labouring and she had no known pre existing history so maybe there is more evidence out there?

[renaldo]

I had a chat with dh about this and apparently the evidence suggests ther is no increased risk of rupture during labour and delivery - would you like me to find the reference?

[Minkyjj]

I have a infundibular neural aneurism which has not been coiled. I have two children and am expecting my third. My first two children were born by c-section as my consulant neurologist said that the greatest risk was high blood pressure and also the 2nd stage of labour - ie the pushing. I opted to have casareans to be on the safe side but that was a while ago so I will be asking advice this time around again from the consultants. What have they said when you asked?

[mosschops30]

Which hospital did your coiling?

Can you speak to your neurologist who may be able to advise. Am sure there must be some good research out there with regards to this.

Ime csection is far more stressful than a vaginal birth

[Lillie75]

Thanks for the responses ladies - not a very common situation I think.

Luckily I have super low blood pressure, which is probably what helped stop my aneurysm from rupturing before I had it treated given its size (big) and location.

I've read several reported medical cases (as well as reading popular reports in the media) of women who have had SAH after labour not having known beforehand that they had an aneurysm.

Renaldo - do you know evidence refers to no increased risk after treatment (either coiling or clipping) or before treatment or either? Would be grateful for the reference if you can find it. I've read some studies which indicate that pre treatment of aneuryms, c-section is preferred delivery method. But have found nothing on post treatment risks.

My neurosurgeon (who incidentally didn't do the coiling for me) thought a vaginal delivery would be ok given it has been coiled and I've had no issues since. My ob said he would talk to my neurosurgeon but I think he will leave it up to me to decide. Have not yet been able to get in touch with the neuroradiologist who did my coiling but thought he would be worth a try as well.

I really don't know at this point. Would go for a c-section but also have endo and adenomyosis, and am a bit worried about a c-section scar causing problems later on. Last thing I want is for the endo to embed in it and the adenomyosis to get worse! Then again - a leaky aneurysm is not too cool either!

[Lillie75]

Just saw your post mosschops30. Cannot find any research looking at the risks (ie actual studies not just opinions). It's a bit surprising - given women are more prone to develop aneurysms!

[mosschops30]

Did you have it one in Cardiff or Sheffield?

[Lillie75]

Hi Mosschops30, I had it done in Bristol at Frenchay. They were excellent. Would recommend them to anyone with an aneurysm who is suitable for coiling. It was a pretty stressful experience - not knowing if I was going to make it through the 4 hour procedure, or wake up with neurological or physical deficit.

I'm not too worried about the surgical or recovery aspects of a c-section. I've had a fair bit of abdominal surgery and a lot of experience of hospitals. If you hadn't had much wrong with you in life and had never had an op or been to hospital, I can imagine a c-section would be a massive shock. I would think a planned section has got to be better than emergency as well, in terms of risk and recovery.

[mosschops30]

Hmm best not get into a debate about c sections with me

Was is Sean Halpin that performed the clipping? He is a leader in the field, works out of Cardiff and also covers other hospitals. Just thought that if you could get in touch with him he may be able to offer some advice.

[Leahparts]

I know this thread is really old now but I was wondering if anybody is in my situation?
I had a subarachnoid haemorrhage on 12th dec 2013 and had it coiled and also have mri scans every year to check on it.

Me and my partner have recently decided we would like to try and conceive. But also had a letter through from my most recent scan explaining that I may have to have recoiling done as original coil has moved some what. I was wondering if anybody has had this procedure whilst in first trimester, it’s to early to test if pregnant yet but I just wanted to see just incase I am?