Chiari 1 Malformation & Pregnancy: What You Need to Know
In a perfect world, all mothers would be healthy and able to carry babies to term and deliver them without any complications or problems. But everyone knows the world is far from perfect. There are medical conditions that can make it nearly impossible for mothers to have an easy pregnancy, labor, and delivery.
One such medical condition is called Chiari 1 malformation, which occurs more often in women than in men. If you've been diagnosed with Chiari or believe that you may have it, here's what you need to know about the condition when you are expecting a baby.
Learn about Chiari 1 Malformation
A Chiari 1 malformation involves the skull and the base of the brain. This malformation in the skull causes the cerebella tonsils (which are at the base of the brain) to herniate through the opening to the spinal column. This can cause the cerebral spinal fluid to be unable to flow correctly and it can also cause an increase in pressure. Since one of the roles of the cerebrospinal fluid is to protect and cushion the brain and spinal cord, this increased pressure often causes intense headaches with immense pressure, which can be described like there's an elephant sitting on the back of your head.
People with Chiari typically experience the pain and intercranial pressure when their head and/or neck strains in some way, such as when coughing, sneezing, laughing, yelling, and/or bending over. When you consider that these types of normal, daily bodily functions can cause headaches and pressure for people, you can definitely understand why someone with Chiari should be concerned about pregnancy and pushing during childbirth.
Deal with Intercranial Pressure
The crowding at the opening to the spinal column, along with an increase in the pressure of the cerebrospinal fluid, can cause a number of various symptoms and affect any number of the various organs in the body, which could affect your baby in the uterus and during childbirth. The crowding simply puts too much pressure on various nerves at the base of the brain.
Because of this, you may experience symptoms such as dizziness, rapid heartbeat, stomach paralysis, and/or sleep apnea. These types of symptoms can progress slowly or come on suddenly, which can definitely affect your baby's health and growth. It's important to inform your ob/gyn specialist and your neurosurgeon of all symptom changes during your pregnancy so they can determine whether or not you need to be put on bed rest.
Treatment for Chiari includes decompression surgery, which is an intensive brain surgery to provide more room for the fluid around the malformation, or the placement of a shunt to relieve the pressure. Of course, neither of these treatment options is recommended during pregnancy due to the risks of infection and other complications that can occur with any major surgery. Your neurosurgeon may prescribe you medication that can help reduce the headaches, pressure, and other symptoms.
Develop a Birth Plan
Given the complexities of Chiari and how it can affect your health as well as the health of your baby, it's important to have your ob/gyn and your neurosurgeon develop a birth plan together. Given that you want to avoid straining and causing an increase in pressure in your head and neck, it's a good idea to consider having your baby via a C-section.
It's also important for your medical team to discuss anesthesia options. A sudden movement of the cerebrospinal fluid could pull the herniation deeper into the spinal column and make the condition worse. Therefore, great care needs to be taken when administering epidurals and/or performing spinal taps.
To learn more about your birthing options with Chiari and for answers to pregnancy questions, contact a representative from an establishment like Rural Health Services Consortium Inc.
