Pregnancy in patients with Chiari malformation and syringomyelia: aspects of interdisciplinary interaction
А.Т. FAYZUTDINOVA1,2, A.R. SHAKUROV2, F.F. ZINNATULLINA2, L.S. FATKHEYEVA2, Ch.R. NURMIYEVA1,2, M.R. YARMUKHAMETOVA1,2, R.I. ZAKIROVA2
1Republic Clinical Hospital of the MH of RT, 138 Orenburgskiy Trakt, Kazan, Russian Federation, 420064
2Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012
Fayzutdinova A.T. ― Cand. Med. Sc., Associate Professor of the Department of Neurology and Rehabilitation, neurologist of the Clinical Expert Department, tel. +7-903-306-44-38, e-mail: aisluzab@mail.ru
Shakurov A.R. ― Cand. Med. Sc., neurologist of the polyclinics, tel. +7-917-395-78-36, e-mail: shakurov-airat@mail.ru
Zinnatullina F.F. ― obstetrician-gynecologist of the Clinical Expert Department, tel. +7-903-306-23-03, e-mail: recoz9202@gmail.com
Fatkheyeva L.S. ― Head of the Clinical Expert Department, tel. +7-903-307-43-93, e-mail: Luiza.Fatheeva@tatar.ru
Nurmiyeva Ch.R. ― Cand. Med. Sc., neurologist of the polyclinics, Assistant of the Department of Neurology and Rehabilitation, tel. +7-927-405-36-72, e-mail: chulpan.nurmieva@mail.ru
Yarmukhametova M.R. ― Cand. Med. Sc., neurologist of the polyclinics, Assistant of the Department of Neurology and Rehabilitation, tel. +7-917-283-92-35, e-mail: jmr-2010@mail.ru
Zakirova R.I. ― resident doctor of the Department of Obstetrics and Gynecology, tel. +7-965-607-73-83, e-mail: recoz9202@gmail.com
The surveillance of pregnancy and childbirth in women with Chiari 1 malformation and/or syringomyelia were analyzed. Features of extragenital pathology, obstetric-gynecological history and bone phenotype are presented. The results of clinical and MRT comparison were examined. The problems of interdisciplinary interaction of obstetricians, neurologists, neurosurgeons, therapists and anesthesiologists are discussed. In the presented series of observations, it was shown that under regular monitoring of pregnant women in specialized medical-preventive establishments pregnancy in women with Chiari malformation type 1 and/or syringomyelia continues to evolve, and concludes with the timely birth of children with no pathology (up to 70%) shown by prenatal screening, not being accompanied by neurological deterioration in women in the early postpartum period (up to 70%).
Key words: Chiari malformation, syringomyelia, pregnancy, childbirth, multidisciplinary interaction.
REFERENCES
- Gilyazutdinova Z.Sh. Beremennost’ i rody pri zabolevaniyakh tsentral’noy i perifericheskoy nervnoy sistemy. Prakticheskoe rukovodstvo [Pregnancy and childbirth in diseases of the central and peripheral nervous system. Practical guidance]. Kazan: Izdatel’stvo Kazanskogo universiteta, 1988. 156 p.
- Akulov M.S., Ershova V.O., Barkovskaya N.A. Delivery in patients with anomaly Arnold-Chiari type 1 (clinical observation). Meditsinskiy al’manakh, 2016, no. 5 (45) October, pp. 47-50 (in Russ.).
- Zabbarova A.T., Bogdanov E.I. The syndrome of the «cramped» posterior cranial cavity and associated neurological symptom complexes. Kazanskiy meditsinskiy zhurnal, 2011, no. 6, pp. 890-896 (in Russ.).
- Milhorat T.H., Chou M.W., Trinidad E.M. et al. Chari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery, 1999, vol. 44, no. 5, pp. 1005-1017.
- Bogdanov E.I. Syringomyelia. Nevrologicheskiy zhurnal, 2005, no. 6, pp. 4-11 (in Russ.).
- Zabbarova A.T., Bogdanov E.I., Khusainova D.K., Fatkheeva L.S. Comorbidity of the syndrome of chronic «cramped» posterior cranial cavity. Kazanskiy med. zhurnal, 2013, no. 2 (March — April), pp. 221-227 (in Russ.).
- Shifman E.M., Kulikov A.V., Lubnin A.Yu. Anesteziya i intensivnaya terapiya u beremennykh s mal’formatsiey Arnol’da ― Kiari. Teoriya i praktika anestezii i intensivnoy terapii v akusherstve i ginekologii. Klinicheskie rekomendatsii. Protokoly lecheniya [Anesthesia and intensive care in pregnant women with malformations of Arnold — Chiari. Theory and practice of anesthesia and intensive care in obstetrics and gynecology. Clinical recommendations. Protocols of treatment], available: www.ARFpoint.ru FEMB Minzdrava RF []. Moscow, 2015. Pp. 199-205.
- Fayzutdinova A.T., Bogdanov E.I. Ways to improve the effectiveness of medical care for adult patients with malformations of Chiari type 1: the role of studying the natural course of the disease and the results of surgical treatment. Prakticheskaya meditsina, 2016, no. 4 (96) August, vol. 2, pp. 127-132 (in Russ.).