MATERNAL NEUROSURGICAL SHUNTS AND PREGNANCY OUTCOME

Objective: To assess pregnancy outcome in women with ventriculoperiton eal or lumboperitoneal shunts. Methods: Charts were reviewed retrospec tively for mothers with ventriculoperitoneal or lumboperitoneal shunts delivered at Hutzel Hospital from 1976-1992. Patients were identified by cross-referencing medical records from Children's Hospital Neurosu rgical Division and medical records at Hutzel Hospital during this per iod. Results: Eight patients with 25 pregnancies were identified from 1976-1992. Indications for shunt placement were pseudotumor cerebri (f our with lumboperitoneal shunts) and congenital hydrocephalus (four wi th ventriculoperitoneal shunts). Pregnancy outcomes were two elective abortions, five spontaneous abortions, two preterm vaginal deliveries, one mid-forceps rotation, two primary low transverse cesareans, two r epeat low transverse cesareans, and 11 spontaneous vaginal deliveries. No patient received prophylactic antibiotics during labor and vaginal delivery because of the shunt. There were no shunt-related complicati ons. Conclusions: This series doubles the number of previously reporte d pregnancy outcomes in women with neurosurgical shunts. Contrary to t he literature suggesting cesarean delivery and prophylactic antibiotic s for all patients, our experience suggests that vaginal delivery can be considered and that prophylactic antibiotics are not an absolute ne cessity in uncomplicated vaginal deliveries. (Obstet Gynecol 1994;83:1 34-7)