Anesthetic Management for Caesarean Section of Pregnant Women Carrying a Brain Tumor

The purpose of the study was to evaluate the anesthetic management for caesarean section of women during pregnancy with a cerebral tumor. It is a retrospective study which was done at the department of neurosurgery of the University Teaching Hospital of Fann and at the department of obstetrics of the University Teaching Hospital of Pikine in Dakar, from July 1, 2008 to June 30, 2015, and included all patients hospitalized for cerebral tumor and presenting an evolutive pregnancy and to whom a caesarean section was done or had been regarded as a possibility. In results We identified 6 cases of cerebral tumor in pregnancy. They presented 2.7 % of all cerebral tumors in women. The average age on diagnosis was 28.2 years. On the whole, the approach was conservative towards the pregnancy and interventionist for the cerebral tumor. The timing for the caesarean section was decided in a collegian faction. Four of the 6 patients underwent a caesarean section after foetal maturation. They all presented intracranial hypertension sighs and general anesthesia was preferably indicated instead of peri medullary anesthesia .The aims of the anesthesia were to avoid foetal distress and the occurrence or aggravation of intracranial hypertension. These two goals contrast each other in practice. Neuroprotective measures were applied after foetal extraction. The caesarean section allowed the birth of live and healthy new borns. The excision of the tumor follows few days later. One of the patients presented a bulky and inoperable cerebral tumor and expired during the management. In conclusion the occurrence of a cerebral tumor during pregnancy is rare but not an exception. The choice of the anesthetic technique for foetal extraction by caesarean section must be adapted in order to preserve the maternal and fetal prognostic.