THE RELEVANCE OF ANEURYSMATIC SUBARACHNOID HEMORRHAGE DURING PREGNANCY

• DOI: https://doi.org/10.22533/at.ed.1594552414062

• Palavras-chave: Aneurysm, intracranial, bleeding.

• Keywords: Aneurysm, intracranial, bleeding.

• Abstract:

   Introduction: Aneurysmal subarachnoid hemorrhage (SAH) is an acute neurological condition that requires immediate intervention and intensive multidisciplinary monitoring. During pregnancy, SAH due to aneurysm rupture presents therapeutic and clinical management challenges, requiring personalized approaches. Methodology: An integrative review of the literature was carried out in PubMed, selecting ten articles from the last ten years (2014-2024) using the descriptor "aneurysmal subarachnoid hemorrhage and emergency intervention and pregnancy" in DeCS/MeSH. Inclusion criteria: studies with pregnant patients with SAH and its management. Exclusion criteria: irrelevant studies, theses and books. Results: Aneurysmal SAH during pregnancy is clinically challenging. Documented cases occur mainly in pregnant women aged 30 or over, and can occur in any trimester, but more frequently in the third. Multidisciplinary approaches are essential to improve maternal-fetal care and reduce morbidity. Diagnostic imaging, such as CT and MRI, is generally safe in the second and third trimesters. Angiograms, necessary to detect aneurysms, require careful assessment of radiation risks. Surgical approaches such as clipping and endovascular embolization are recommended, with preference for endovascular intervention. Cesarean section is generally favored in cases of ruptured aneurysms. Conclusion: The management of SAH during pregnancy requires a multidisciplinary and individualized approach. Current guidelines, while helpful, have limitations. Systematically reviewing recommendations and integrating updated evidence are essential to improving maternal-fetal outcomes.