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- W2913708639 abstract "Introduction: Understanding the risk of aneurysmal subarachnoid hemorrhage in pregnant women with known history of Unruptured Intracranial Aneurysm (UICA) could potentially impact the delivery method. Due to presumed risk of intrapartum aneurysm rupture, understanding practice patterns of delivery methods and related complication risk is of importance. Methods: We used Nationwide Inpatient Sample database (1998-2014) to identify all the hospitalizations for childbirth in women with and without history of UICA. Patients with intracranial vascular malformation and traumatic intracranial hemorrhage were excluded. The cohort of pregnant women with known history of UICA was compared with the cohort of those without history of UICA with univariate analysis. Results: A total of 323 patients with known history of UICA were hospitalized for childbirth compared to 13,669,848 with no history of UICA. Higher rates of intracranial hemorrhage was observed in history of UICA group compared to no history of UICA [subarachnoid hemorrhage (0.31% Vs 0.001%, p<0.01), intracerebral hemorrhage (0.94% Vs 0.001%, p<0.01), and non-specific intracranial hemorrhage (0.28% Vs 0.0004%, p<0.01)]. UICA group had higher incidence of essential hypertension (6.9% Vs 1.1%, p<0.01), pre-eclampsia (7.1% Vs 3.5%, p<0.01), and eclampsia (0.6% Vs 0.07%, p<0.01), and prevalence of smoking (8.23% Vs 3.95%, p<0.01). The rate of cesarean section (78.8% Vs 29.6%, p<0.01) and length of average hospital stay (3.76 Vs 2.57 days, p<0.01) was higher in UICA group. UICA group had higher rates of major anesthesia complications (0.32% Vs 0.01%, p<0.01), prolonged mechanical ventilation (1.2% Vs 0.04%, p<0.01), and blood transfusion (3.12% Vs 0.75%, p<0.01). 80% of UICA patients who had intracranial hemorrhage also had cesarean section. Conclusion: Women undergoing childbirth with known history of UICA have higher risk of intracranial hemorrhage, peripartum complications, and longer hospitalizations compared to women without a known UICA. Aggressive management of risk factors for aneurysm rupture including hypertension and smoking could potentially decrease the rupture risk. Further research is needed to understand whether delivery method has an impact on decreasing risk of rupture." @default.
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- W2913708639 date "2019-02-01" @default.
- W2913708639 modified "2023-09-27" @default.
- W2913708639 title "Abstract WP122: Risk of Intracranial Hemorrhage and National Trends of Delivery Methods of Pregnant Women With Diagnosis of Unruptured Intracranial Aneurysm" @default.
- W2913708639 doi "https://doi.org/10.1161/str.50.suppl_1.wp122" @default.
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