Evidence map›Paper›PMID 33640891›Full record

ArticleCerebrovascular diseases (Basel, Switzerland)2021

Maternal and Fetal Outcomes in Women with Brain Arteriovenous Malformation Rupture during Pregnancy.

Kimberly L Yan, Nerissa U Ko, Steven W Hetts, Shantel Weinsheimer, Adib A Abla, Michael T Lawton, Helen Kim

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cerebrovascular diseases (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Arteriovenous Malformation Hemorrhage in Pregnancy: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Kimberly L YanCenter for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California - San Francisco, San Francisco, California, USA.
Nerissa U KoDepartment of Neurology, University of California - San Francisco, San Francisco, California, USA.
Steven W HettsDepartment of Radiology and Biomedical Engineering, University of California - San Francisco, San Francisco, California, USA.
Shantel WeinsheimerCenter for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California - San Francisco, San Francisco, California, USA.
Adib A AblaDepartment of Neurological Surgery, University of California - San Francisco, San Francisco, California, USA.
Michael T LawtonDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Helen KimCenter for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California - San Francisco, San Francisco, California, USA, Helen.Kim2@ucsf.edu.
University of California, San Francisco · USBarrow Neurological Institute · USUniversity of California, Los Angeles · US

Funding

PREDICTORS OF SPONTANEOUS CEREBRAL AVM HEMORRHAGER01NS034949 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KIM, HELEN · 1995 to 2017
$6.5M
Long-term outcomes in unruptured brain arteriovenous malformation patientsR01NS099268 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KIM, HELEN · 2017 to 2021
$3.1M
NINDS NIH HHS R01 NS034949NINDS NIH HHS R01 NS099268
6 · The paper itself

Abstract

backgroundSporadic brain arteriovenous malformations (BAVM) are a major cause of hemorrhagic stroke in younger persons. Prior studies have reported contradictory results regarding the risk of hemorrhage during pregnancy, and there are no standard guidelines for the management of pregnant women who present with BAVM rupture. The purpose of this study is to describe maternal and fetal outcomes and treatment strategies in patients with BAVM hemorrhage during pregnancy.

methodsWe performed a retrospective review of the University of California, San Francisco Brain AVM Project database for female patients who were pregnant at the time of BAVM hemorrhage between 2000 and 2017. Clinical and angiographic characteristics at presentation, BAVM treatment, and maternal outcomes using modified Rankin scale (mRS) score at presentation and 2-year follow-up were recorded. Fetal outcomes were abstracted from medical records and maternal reports.

resultsSixteen patients presented with BAVM hemorrhage during pregnancy, 81% (n = 13) of whom were in their second or third trimester. Three patients (19%) who were in their first trimester terminated or miscarried pregnancy prior to BAVM intervention. Of the remaining 13 patients, 77% (n = 10) received emergent BAVM treatment at time of hemorrhage prior to delivery, and 85% of patients achieved BAVM obliteration and good maternal outcomes (mRS 0-2) at 2-year follow-up. All patients had uncomplicated deliveries (69% cesarean and 23% vaginal) with no reports of postnatal cognitive or developmental delays in infants at 2-year follow-up.

conclusionsOur study shows good long-term maternal and fetal outcomes in ruptured BAVM patients presenting during pregnancy, the majority who received BAVM interventional treatment prior to delivery.

Indexed as

Pregnancy Complications, CardiovascularAbortion, SpontaneousAdultDatabases, FactualFemaleHumansIntracranial Arteriovenous MalformationsIntracranial HemorrhagesLive BirthPregnancyRetrospective StudiesRisk FactorsRupture, SpontaneousSan FranciscoTime FactorsTreatment OutcomeCerebral arteriovenous malformationHemorrhageOutcomePregnancyStroke in women

Identifiers

PMID33640891
PMCPMC8159887
OpenAlexW3134178820

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.