Course of Pregnancy in Patients with Idiopathic Intracranial Hypertension: A Case Series

Background

Idiopathic Intracranial Hypertension (IIH) is a disease of unknown aetiology which predominantly affects obese women of childbearing age. It can present as a medical and obstetrical challenge to clinicians unfamiliar with the management in context of pregnancy. Its course can mimic obstetric complications like imminent eclampsia. Despite being an obstetrical challenge, only about 50 pregnancies have been reported in literature so far.

Methods

This is a retrospective analysis of cases taken from a tertiary care institute attending a special multidisciplinary clinic run by experienced obstetricians, neurologists and neonatologists. Clinical profile, course of pregnancy and outcome of seven patients selected in our case series will be discussed.

Results

Patients were in the age group of 25-32 years. Out of 7 patients, 4 underwent caesarean section; 2 of these were for obstetric indication (transverse lie and Meconium). Out of 4 caesareans, only 1 was done under spinal anaesthesia. Out of 7 deliveries, 6 were at term and 1 was a preterm caesarean done in view of premature prelabour rupture of membranes with meconium stained liquor. Neonatal outcome was favourable in all 7 cases with a good Apgar score.

Conclusion

Normal vaginal delivery can be allowed in patients with IIH. IIH doesn’t alter the course of pregnancy nor does the course of disease change due to pregnancy. Medical management or lumbar punctures can be safely done without altering the course of pregnancy. Neonatal outcome is also favourable. Adequate labour analgesia is important.

Author(s):

Aggarwal N

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