neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"neurosurgery-135Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWТактика лечения церебральных артериовенозных мальформаций у беременныхThe treatment strategy concerning arteriovenous malformations at pregnant womenБуршиновАлександр ОлеговичBurshinovA. O.neyrogin@gmail.comПорошниченкоАлександр ИгоревичPoroshnichenkoA. I.neyrogin@gmail.comГосударственное бюджетное образовательное учреждение высшего профессионального образования «Рязанский государственный медицинский университет имени академика И.П. Павлова» Министерства здравоохранения Российской ФедерацииRussian FederationГосударственное бюджетное учреждение Рязанской области «Областной клинический перинатальный центр»Russian Federation201405102017049296Copyright © Буршинов А.О., Порошниченко А.И., 20172017Буршинов А.О., Порошниченко А.И.Burshinov A.O., Poroshnichenko A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/135

Разрыв внутричерепной артериовенозной мальформации (АВМ) во время беременности - редкое, но опасное состояние, приводящее к высокой материнской перинатальной смертности. В обзоре обсуждаются вопросы влияния беременности на риск разрыва АВМ, представлены основные подходы к лечебной тактике при данной патологии, выбору метода обезболивания и родоразрешения. В большинстве случаев разрыв АВМ во время беременности требует немедленного оперативного лечения из-за опасности повторного кровоизлияния. На основании имеющихся данных литературы, эндоваскулярная эмболизация с последующей хирургической резекцией АВМ являются наиболее эффективным методом лечения. При неразорвавшейся АВМ многие авторы рекомендуют консервативное ведение беременности, снижающее риск внутримозгового кровоизлияния (контроль АД, терапия гестоза).

The rupture of intracranial arteriovenous malformation (AVM) during pregnancy is a rare but dangerous event associated with a high perinatal mortality. This review discusses the influence of pregnancy on the AVM rupture as well as presents the main principles of treatment strategy for such pathology and the choice of anesthesia method and types of delivery. The AVM rupture during pregnancy requires immediate surgery in the most cases because of high risk of re-bleeding. The endovascular embolization followed by surgical excision of the AVM is the most effective treatment according to the available data in the literature. Concerning the unruptured AVMs revealed during pregnancy the conservative management of pregnancy is recommended to reduce the risk of intracerebral hemorrhage (arterial blood pressure control, treatment of preeclampsia).

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The authors declare that there are no conflicts of interest present.