Arteriovenous Malformation in the Pregnant Patient: A Case Study

Abstract

Subarachnoid hemorrhage (SAH) due to ruptured arteriovenous malformation (AVM) or aneurysm accounts for 4.4% of all maternal deaths. It is the third most common nonobstetric cause of maternal death. Significant differences, such as timing of the initial bleed and rebleeding, exist between aneurysmal and AVM related SAH. Increased risk of AVM related SAH appears to correlate with the augmented cardiac output of pregnancy, as well as with other coagulation, hemodynamic and endocrinological changes. These changes usually occur between 20 weeks gestation and 6 weeks postpartum. All suspicious neurological signs and symptoms in the gravid patient should be thoroughly evaluated. Although the nursing care of the pregnant patient with an AVM is similar to that of nonpregnant patients, there are specific clinical observations that are relevant to these patients.