Brain Tumors During Pregnancy
The diagnosis of a brain tumor is challenging for any patient, but it is especially challenging for a pregnant woman. It is a dramatic and difficult event for her and her family as well as the medical team taking care of her. The unique physiologic state of pregnancy creates challenges and affects the timing of treatment for the pregnant patient. Unfortunately, the lack of comprehensive data on the care of pregnant patients diagnosed with brain tumors and the management of this group of patients poses diagnostic and therapeutic challenges. In addition, it is necessary to consider the nature of the tumor, the presentation of the patient, and the timing in pregnancy to determine the best treatment and to determine whether or not to carry out the pregnancy. This portends multiple implications involving medical, social, moral, and religious considerations for the patient, her family, and her medical team. Improved understanding of the optimal medical treatments for this group of patients as well as developments in surgical and anesthetic techniques have resulted in improved ability to care for these patients while decreasing pregnancy complications. Many studies have described a relapsing pattern in tumors relative to pregnancy, menstruation, and menopausal status. Steroid hormones may play a role in the development of some brain tumors, such as meningiomas. However, literature reviews and population-based studies indicate that the incidence of brain tumors in pregnant women is actually equal to or lower than that in age-matched nonpregnant women. This chapter describes the brain tumors that occur most frequently in women of childbearing age, their common initial signs and symptoms, their impact on gestation, and the medical and surgical management of brain tumors while minimizing the risks to the fetus.
