A case of subarachnoid hemorrhage（SAH）at 36 weeks of gestational age

• Published in: Journal of Japan Society of Perinatal and Neonatal Medicine Vol. 56; no. 3; pp. 482 - 486
• Main Authors: Ando, Mariko, Yoshida, Yu, Shimada, Yukiyo, Ichimiya, Mariko, Onjo, Sachiko, Nishida, Makoto
• Format: Journal Article
• Language: Japanese
• Published: Japan Society of Perinatal and Neonatal Medicine 2020
• Subjects: cerebral aneurysm; endovascular treatment; pregnancy; subarachnoid hemorrhage
• ISSN: 1348-964X; 2435-4996
• DOI: 10.34456/jjspnm.56.3_482

Subarachnoid hemorrhage（SAH）during pregnancy is a rare but increasingly reported condition with high mortality. We experienced a case of SAH at 36 weeks of gestational age with good maternal and fetal outcomes. A 32-year-old woman with a severe headache was transferred to the emergency room. Head CT revealed SAH caused by rupture of an intracerebral aneurysm, located between the left internal carotid artery and posterior communicating artery. She experienced no disturbance of consciousness or problems with vital signs. Furthermore, the fetal heartbeat indicated reassuring status, and the fetus was deemed sufficiently mature considering the gestational age. Therefore, an embolization procedure was performed following emergency cesarean section under general anesthesia. Concerning the treatment strategy for SAH during pregnancy, saving the mother’s life should take precedence. The choice of treatment for the aneurysm and the time of delivery should be evaluated on a case-by-case basis according to the status of pregnancy and severity of the mother’s clinical condition. Early diagnosis and accurate management can reduce maternal and fetal mortality.