Preganancy Outcome in a patient with Moyamoya Disease

• Author Details:   
• Maya Menon
• T. A. Sridevi

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Moyamoya disease is a rare cerebrovascular occlusive disorder characterised by bilateral stenosis of terminal portion of the internal carotid artery near circle of Willis. This is a case of 28 yrs primigravida diagnosed as childhood stroke secondary to Moyamoya disease with left hemiparesis on antiepileptic drugs booked under combined care of obstetrician and neurologist was started on anticoagulant along with iron, calcium and folic acid. Antenatal period was uneventful. Patient had spontaneous on set of labour and had a assisted vaginal (vacuum) delivery, alive female baby was delivered with Apgar score of 8/10. Care was taken to avoid dehydration and hypotension during the peripartum period. There are no prospective trials that address the safest mode of delivery for women with MMD. Pregnant patient should be counselled about the risk and potential benefit of medical and surgical treatment and managed by multidisciplinary team of obstetrician, neurologist, neurosurgeon and anesthesiologist.