New Research: Pregnancy and Cavernous Malformation

A new study, published in the journal Stroke, investigated whether pregnancy increases hemorrhage risk for women with cavernous malformations (cavernous malformation, cavernoma). Results showed that hemorrhage risk, in fact, does not appear to increase during pregnancy. Furthermore, the study indicated that vaginal delivery also appears safe in women with cavernous malformations, if they don’t have other significant health issues that warrant caesarian section.

This study, conducted by Mayo Clinic, examined prospectively collected data from 160 women who were part of a larger cavernous malformation registry database. The goal was to assess the influence of pregnancy on the risk of hemorrhage after cavernous malformation diagnosis, during pregnant and non-pregnant states in women of childbearing age.

In total, 365 pregnancies were captured among the 160 women followed, all of whom had a brain or spinal cord cavernous malformation. Only 4 of the 160 women experienced a hemorrhage while pregnant. None experienced hemorrhage during delivery. Among the four women who hemorrhaged, all were diagnosed with a cavernous malformation as a result of the hemorrhage during pregnancy, rather than before the pregnancy. Thirty-two of the 160 total women became pregnant after their diagnosis of cavernous malformation and none of these women experienced a hemorrhage during pregnancy.

Similar studies conducted by researchers in the past also found that the incidence rate of hemorrhage occurring while pregnant was very low in women with known cavernous malformation. Furthermore, no cases of hemorrhage during delivery were found in any other published research.

Co-author of this article, Dr. Kelly Flemming, explains the importance of this research: “We have confirmed with this paper what others have published regarding pregnancy and cavernous malformation, which is that the risk of bleeding during pregnancy is not increased.   We used a slightly different methodology than prior investigators by assessing the risk of pregnancy only AFTER the diagnosis of cavernous malformation was made.  We are also reassured that vaginal delivery is safe in most patients.”

Although more research needs to be done to further examine cases of women that do experience a hemorrhage while pregnant, and formal guidelines need to be developed to manage their care, this research can help women with cavernous malformations, and their doctors, to feel more comfortable and confident while making important family planning decisions.

More information about Pregnancy with Cavernous Angioma.