Pregnancy/delivery with brain aneurysm

[Avriljen]

Hi, I'm currently 12 weeks pregnant. I have an brain aneurysm which has been treated with a stent. I saw the consultant for the first time last week and she thinks I will probably need a c-section, although there is a chance I could still have a natural delivery, she was pretty honest and said she doesn't actually have a clue but is going to check with my neurosurgeons. I won't see her again for another 6 weeks so just thought I'd see if anyone has any experience of this so I don't have to wait 6 weeks for an answer!

Hi, hope you are okay and the pregnancy is going well. I just came across your post and was wondering if I could steal some advice. I am 16weeks pregnant and just found out I have an unruptured aneurysm on my basilar artery. My obstetrician said it shouldn't affect having a natural delivery but I'm concerned the pushing will increase the chances of it bursting. I know your case is slightly different as you have a stent in place but what did your doctor advise you of in the end? I don't know whether I should air on the side of caution and go for a caesarean or trust the doctors.
Thanks for any advise you can offer :)

Hi, congratulations on your pregnancy! I'm now 31 weeks and everything is going well.
My neurosurgeons have said I don't need a caesarean, which worries me slightly, I do feel it would be safer but they are happy for me to try for natural delivery. When I met with the anaesthetist she advised that I have an epidural, her aim is to keep me as comfortable as possible to stop big spikes in blood pressure. I haven't done a birth plan yet and still have caesarean in the back of my head but I know the recovery from that can take ages so think I'll be trying for natural.(unless I panic closer to the time!)
Have you seen a neurosurgeon? They are the best to advise you, my obstetrician said she didn't know enough about it. I would have thought in your case it might be a bit riskier because you've had no treatment, but I suppose it will depend on the size of the aneurysm. Mine was quite big so was treated within 2 weeks of finding it.
Hope everything else is going well!

Whenever a pregnant woman has a significant health condition that might be aggravated by mode of delivery, it is best practice to ask their specialist team for guidance.
As a midwife, I have cared for many people in this situation eg
: brain aneurysm, treated and non treated
: retinal detachment, ditto
: cardiac issues

The vast majority are advised that normal delivery is a safe option for them.

Slightly different situation but I have a brain tumour (diagnosed at 13 wks pregnant) and my Neurosurgeon is happy for me to have a natural delivery as long as it's at the hospital with the neurosurgery specialists (rather than a local one). There are risks of seizures, swelling and rupture in my case, and I think he's swayed by the fact that I need the tumour removing soon after baby arrives (currently 33+2) so he wants to avoid extra surgery. My obstetrics team were clear that they want me to have a shortened second stage (pushing) before they intervene - in my case I get 30 mins rather than the usual 2 hours - then likely to be forceps etc. so that might be a consideration in your situations too to reduce risks?

Thanks for the replies. Glad to hear your pregnancy is going well 😊
I have a neurologist already as I have epilepsy and will be seeing him in November. I also spoke to my GP today who will refer me back up to Charing Cross, where the scans were done and where my mum had her brain surgery when her aneurysm burst in Dec 2014.

I do feel anxious at the thought of natural delivery now. I was all for it before getting the news but now am terrified. I think unless the doctors say they are 100% sure it won't rupture then I will plump for a caesarean, but I'm equally terrified of major abdominal surgery! I just can't think straight but I suppose I have 24 weeks to think about it. It just makes sense to me not to push as a lot of brain aneurysms rupture when people are going to the loo...

Hopefully my neurologist and my soon-to-be booked neurosurgery appointment can allay some fears but I have a habit of being a bit of a pessimist 😕

Dobby and Avriljen, you are both in a good position.
You actually know it's there, so a safe plan can be made.
You will see a specialist who will have seen many women with your condition go through pregnancies
In this country, your views and preferences about risk will be taken seriously, so you will be listened to.
You will be a "special" client on labour ward, you'll have a midwife glued to your side, however this baby is born.

Best wishes for safe births