Abstract
Tokyo metropolitan established a new maternal emergency medical system in 2009. A 29-year-old woman who was 39 weeks into her pregnancy presented with a headache and hemiplegia. She was brought to our hospital using this system. A brain CT showed intracerebral hemorrhage. An emergency cesarean section and craniotomy were performed. Postoperative cerebral angiography revealed the presence of moyamoya disease. The patient did not recover from a vegetative state. However, her baby was discharged healthy. Although pregnancy-related stroke is one of the most frequently reported maternal emergencies, there are no definitive guidelines for the management of these patients. Early control of the airway is indicated in addition to ensuring appropriate ventilation. It is recommended that blood pressure should be kept below 160/100 mmHg. Changes in hemodynamic status due to pregnancy must be considered in light of the effects that potential treatments may have on the fetus. Management of these cases should be multidisciplinary because it is necessary to monitor the status of both the mother and the fetus throughout treatment. Maternal emergencies not only require collaboration between emergency medicine and obstetric departments but also support from the entire hospital and emergency medical system to provide immediate and accurate intervention.
