Hydrocephalus during pregnancy with or without neurosurgical past history in childhood.

Many women with cerebrospinal fluid shunts are now reaching reproductive ag e. Clinical management of pregnant patients with hydrocephalus should inclu de preconception counseling and CT scan or MRI. A family pedigree should al so be established for counseling on the risk of recurrence of the woman's r endition or another neural tube defect. Electrophoresis of acetylcholineste rase in the amniotic fluid can provide the diagnosis of open neural tribe d efect between 13 and 24 weeks gestation. Shunt malfunction may occur during pregnancy in 50 % of cases. Management r equires well-planned, a combined neurosurgical and obstetrical approach. Va ginal delivery is possible in asymptomatic mothers. Cesarean section is rec ommended for neurologically unstable patients. Prophylactic antibiotics are recommended for labor and delivery to avoid shunt infection. Epidural anal gesia is contraindicated in patients with intracranial hypertension. Some complications of complementary treatment for cerebral tumors in childh ood are briefly reported.