Solanke SS*, Pednekar R**, Parulekar SV***.
(* Third Year Resident, ** Assistant Professor, *** Professor and Head, Department of Obstetrics and Gynecology, Seth G S Medical College & K E M Hospital, Mumbai, India.)
Central nervous system diseases, including intracranial tumors, particularly malignant brain tumors and trauma, remain a leading cause of indirect maternal mortality. Primary central nervous system tumors occur in about 6 in 100000 females, but are rare during pregnancy. A study reported the incidence of maternal malignant brain tumors at 3.6 per 1 million live births. The management of pregnant women with malignant brain tumors has not been well evaluated. The present study reports a case of a pregnant woman in the third trimester with a glioma. The patient underwent craniotomy for brain tumor resection under general anesthesia at 36 weeks of gestation and had a spontaneous by preterm vaginal delivery at 36 weeks and 4 days of gestation.
Our patient had a lucky outcome. The time of presentation was at a reasonably advanced gestational age, so that the childbirth had to be deferred only for a few weeks, postponing radio- and/or chemotherapy. Her surgery was successful and there were no neurological postoperative complications. She went into spontaneous labor, progressed and delivered vaginally without any mishap. We have presented this case so that the number of cases of gliomas in pregnancy increases and an analysis of a large number of such cases in future can help one draw meaningful conclusions.
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We thank Dr Chagla AS and Dr. Akshay Hadwalkar from department of neurosurgery for neurosurgical management of the patient.