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Hi, my name is Tasha and I was diagnosed with SLE over three years ago after the birth of my second child. I am currently 33 weeks pregnant and have been suffering for the past 6 months with severe headaches. I have been hospitalized several times and have had lumbar punctures and steroid treatment to deal with the headaches. They have decreased in severity but I still have headache everyday.
Now my ob/gyn and neurologist are trying to convince me to have a caeserean rather than natural labor to avoid risks related to increased intracranial hypertension. My MRI's have all been normal but the lumbar puncture did show elevated pressure and I am having problems with my eyes due to the increased pressure. I am wondering if anyone reading this post has experienced similar problems during pregnancy and can advise me regarding their labor and delivery.
 

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Hi Tasha,

Congratulations on your pregnacy. You have a hard choice on your hands. I have 4 children and only managed to avoid c-section by the skin of my teeth.

Have you asked your ob/gyn and neurologists what the percentages (odds are) are of incurring problems. Sometimes its much clearer if they can tell you in % (percentage) terms what the risks are. Have you consulted an eye specialist regarding the pressures in your eyes - perhaps his opinion would be useful to!

What about having an epidural, then if labour still stresses your body then the c-section if required. I know an epidural helped me get through labour with high blood pressure along with syntanox (I think this speeds up labour) without c-section. My longest labour luckily was only 7.5 hours and shortest 2.5 hours.

Perhaps you can suggest epidural to see what their reaction is! Obviously you have to be cautious whatever descision is, but for peace of mind you need to be in control and comfortable with that choice, but still respect the specialist concerns.

Have you a partner or family to help you decide - I hope you do!

Take care, try not to worry and let us know how you get on!

Love

Lesley
 

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I have no experience with this, but can give you a link to a website that has a little information on it at least. It sounds like babies have been delivered vaginally in women with this condition. I think you will need to take a wait and see attitude towards this, and hopefully your doctor will too. If your vision is impaired/at risk significantly when the time for delivery approaches, then I'd follow your doctors recommendation if it were me.

Here is the link (you may want to review the whole site as well!):

http://groups.msn.com/pseudotumorcerebri/articlespage1.msnw

Good luck & congratulations & Welcome to our site :)
 

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Hi Tas,

I know nothing at all about this condition in pregnancy and labour but thought this article might be helpful to you:

From Medscape General Medicine

MedGenMed Ob/Gyn & Women's Health



Management of Idiopathic Intracranial Hypertension in Pregnancy

Rosa A Tang, MD, MPH
Author Information

Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure without hydrocephalus or mass lesion with elevated cerebrospinal fluid (CSF) pressure but otherwise normal CSF composition (Modified Dandy's criteria).[1] Pregnancy occurs in IIH at about the same rate as in the general population and can occur in any trimester of pregnancy. Affected patients have the same spontaneous abortion rate as that of the general population, and the visual outcome is the same as for nonpregnant patients with IIH.[2,3] In this issue of Medscape General Medicine, Bagga and colleagues[4] report on 3 women with IIH during pregnancy and review choices for therapy and mode of delivery.

Although the general recommendation is that pregnant patients with IIH be managed and treated the same way as any other patient with IIH, the 2 groups should be managed differently with regard to the use of imaging and drug contraindications. Treatment should be administered with 2 major goals in mind: preservation of vision and symptom resolution. Medical therapy includes weight control, nonketotic diet, serial lumbar punctures, diuretics, steroids, and certain analgesics.[5] When medical therapy aimed at salvaging vision fails, surgical procedures need to be considered. The 2 main procedures are optic nerve sheath fenestration and lumbo-peritoneal (LP) shunt.

The proper method and use of anesthesia during delivery, especially when surgery has been performed, is a valid concern raised by Bagga and colleagues.[2] Spinal anesthesia has been shown to be safe and effective in a patient with IIH without a prior LP shunt.[6,7] In pregnant patients with a preexisting LP shunt, general anesthesia for cesarean section has been recommended over epidural anesthesia because of the potential damage to the shunt during epidural placement.[6] It should be noted, however, that the evidence is only anecdotal. In addition, general anesthesia in pregnant patients, particularly those who are obese - ie, the typical patient with IIH -- carries multiple risks, including aspiration and airway problems, and it is thus generally best avoided if possible.[7]


Case reports indicate that in pregnant patients with preexisting CSF shunts, proper management can lead to normal pregnancy, and decisions regarding the mode of delivery, anesthesia, and analgesia should be based only on obstetric concerns.[7] The use of outlet forceps has been suggested to prevent prolonged second-stage labor in patients with IIH, but it is not established that a prolonged second stage of labor is a cause for concern. A cesarean section is not required, nor is sterilization. Therapeutic abortion to limit progression of disease is not indicated, and subsequent pregnancies do not increase the risk of recurrence of IIH.[7]
http://www.medscape.com/viewarticle/516116

I wish you well with the delivery and a happy and healthy outcome for both of you :)

love
Lily
 
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