Pregnancy and delivery in women with tumors of central nervous system (Clinical observation)

Abstract

The tumors of the central nervous system (CNS) in women commonly are diagnosed at the age of 35-45 years old. Their rate is about 2-3.2 cases per 100,000. The tumors of the CNS are not a common problem during pregnancy, however annually 4-5 women with this diagnosis visit the Department of Internal Pathology of Pregnant Women in the State Institution “Institute of Pediatrics, Obstetrics and Gynecology named after academic О.M. Lukyanova of National Academy of Medical Sciences of Ukraine”.The risk of CNS tumor development during pregnancy is identical that in non-pregnant women, but pregnancy affects the pathophysiology of the tumor. The main factor that significantly worsens the course of the CNS tumors in pregnant women is the combined effect of biologically active substances, such as endothelial growth factor and placental growth factor, with immunological tolerance. The absence of clinical guidelines and recommendations for pregnancy and childbirth in such patients makes this problem particularly relevant. The article analyzes the scientific publications of 2020-2021, which are devoted to the problem of CNS tumors during pregnancy, their diagnosis, treatment, including surgery, methods and time of delivery, which are depended on the type of tumor, its location and stages. Our own five-year clinical observations of pregnancy and childbirth in women with CNS tumors are presented. Pregnancies in women with meningioma, cavernous angioma, cerebellar astrocytoma, pituitary macroadenoma, neurinoma, hemoblastoma, intracellular tumor with germination in the third ventricle and histologically unverified intracerebral tumor have been described.We compared the results of the foreign colleges with the experience of the Department of Internal Pathology of Pregnant Women in the State Institution “Institute of Pediatrics, Obstetrics and Gynecology named after academic О.M. Lukyanova of National Academy of Medical Sciences of Ukraine”. Based on this work, the recommendations for the management and delivery of pregnant women with tumors of the central nervous system have been developed.