Moyamoya disease in pregnancy: a systematic review

Abstract

MMD may coincide with pregnancy, but there is paucity of high-quality data. It appears that MMD is not a contraindication to pregnancy, if blood pressure and ventilation are properly managed. There is no clear evidence that bypass surgery before pregnancy or cesarean mode of delivery improve outcomes.

Postpartum Seizure and Subarachnoid Haemorrhage Secondary to Moyamoya Disease

“…None of these 15 women presented with postpartum seizures as the first presentation of Moyamoya disease [3]. These women presented with ischaemic events (79%) or haemorrhagic events (21%) [3]. Our case uniquely describes a woman who presented minutes after the second stage of labour with a seizure.…”

“…It has been described in pregnant women [3]. However, we describe a unique case of an immediate postpartum complication.…”

“…Only a few cases of Moyamoya disease have been described in pregnancy. A systematic review reported 96 women diagnosed before pregnancy, 23 women during pregnancy, and only 15 postpartum of which seven were diagnosed within three days postpartum [3]. None of these 15 women presented with postpartum seizures as the first presentation of Moyamoya disease [3].…”

“…A systematic review reported 96 women diagnosed before pregnancy, 23 women during pregnancy, and only 15 postpartum of which seven were diagnosed within three days postpartum [3]. None of these 15 women presented with postpartum seizures as the first presentation of Moyamoya disease [3]. These women presented with ischaemic events (79%) or haemorrhagic events (21%) [3].…”

Transition to Adulthood for Pediatric Moyamoya Patients

“…If possible, cerebral revascularization prior to becoming pregnant (if surgery is warranted) confers some degree of protection from stroke. 23 A major risk factor for stroke-particularly hemorrhagic stroke-during pregnancy is uncontrolled hypertension, suggesting that careful obstetrical monitoring and early steps to control blood pressure may be important. 24 While many centers choose cesarean section as the default method of delivery, healthy vaginal births are certainly possible, with the caveat that pain management (often with an epidural catheter) and avoidance of hyperventilation are crucial.…”