Abstract Details

Title Management of Idiopathic Intracranial Hypertension in Pregnancy

Topic General Neurology

Presentation(s) S27 - General Neurology 2 (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Background Management of IIH in pregnancy is an enormous challenge for the neurologists and maternal medicine specialists who care for these women. Acetazolamide is an effective treatment for IIH, but its effects on offspring are unknown. Vaginal delivery raises concern for potential worsening of the condition. The safety of neuraxial anesthesia has not been previously assessed.

Objective To evaluate the safety of vaginal delivery and neuraxial anesthesia in women with idiopathic intracranial hypertension (IIH) and to examine the effects of the use of acetazolamide on neonatal outcomes.

Design/Methods An electronic chart review was conducted to identify 180 pregnancies in women with IIH who received medical care within our health system between 2013 and 2023. Inclusion criteria included opening CSF pressure at or above 260 mm H2O pressure. Data collected included: neonatal acetazolamide trimester of exposure and dose, spontaneous abortions, fetal demise, congenital anomalies, gestational age, length, weight, and head circumference at birth, APGAR scores, fetal health status at delivery, indication and mode of delivery, mode of anesthesia, and maternal complications of pregnancy and delivery.

Results There was no significant difference in the rate of congenital anomalies (p = 0.3566) or spontaneous abortion (p = >0.9999) between acetazolamide-exposed offspring and non-acetazolamide-exposed offspring. There were no incidences of neurologic demise or visual loss in any of the patients, regardless of vaginal or cesarean section or type of anesthesia.

Conclusions This study of 180 pregnancies of women with IIH revealed no neurologic deterioration who underwent vaginal delivery, epidural, or spinal anesthesia. While this study is limited in size, no adverse effects of acetazolamide on offspring were noted.

Authors/Disclosures
Kendall A. Curtis PRESENTER	Miss Curtis has nothing to disclose.
Srividya Kottapalli, BS	Miss Kottapalli has nothing to disclose.
Erica Kemp (UPMC)	Ms. Kemp has nothing to disclose.
Janet F. Waters, MD, FAAN (University of Pittsburgh Physicians)	An immediate family member of Dr. Waters has received personal compensation for serving as an employee of Haemonetics. An immediate family member of Dr. Waters has received personal compensation for serving as an employee of Vitalant. An immediate family member of Dr. Waters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Haemonetics. An immediate family member of Dr. Waters has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vitalant. An immediate family member of Dr. Waters has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Vitalant. An immediate family member of Dr. Waters has received publishing royalties from a publication relating to health care.

��ɫ��

��ɫ��