Presentations

Abstract

Introduction: Meningioma in pregnancy is a rare diagnosis, and there is no level I or II evidence to guide clinical management or assist in patient counseling. This review's objective is to summarize the available evidence describing maternal outcomes associated with newly diagnosed meningioma in the peripartum period.

Main Body: A systematic review of 5 databases was performed 7/2024 for any study type published from the year 2000 onward and reporting on pregnant or postpartum (within 1 year) human subjects diagnosed with any meningioma type. Non-English language, commentaries/editorials, letters/responses, video abstracts, and other reviews were excluded. Analysis was performed using Covidence Systematic Review Software. After de-duplication, two authors independently screened abstracts for eligibility and reviewed potentially eligible full-text articles for inclusion, with disagreements resolved by a third author. The risk of bias was also independently assessed by two authors. The primary outcomes were quantitatively synthesized descriptive analyses of pregnancy management and patient outcomes. The initial search yielded 4853 publications (2232 Embase, 1564 PubMed, 870 Web of Science, 102 ClinicalTrials.gov, 85 CENTRAL). After de-duplication, 3647 were title/abstract screened, 210 were full text screened, and 111 were included (Fig. 1). Greater than one in four cases presented prenatally, at a mean gestational age of 27 (±7) weeks, and diagnosis was most often made by Magnetic Resonance Imaging without contrast. Just over half of cases were delivered at full term, the majority by Cesarean section. Most reported cases were treated with craniotomy during pregnancy or immediately postpartum. There were 5 maternal deaths due to neurologic deterioration. No neonatal deaths were reported.

Conclusion: This review highlights the sparse clinical data available to guide clinical management and adequate patient counseling in cases of meningioma diagnosed in the peripartum period, and demonstrates the need for a national registry for meningioma in pregnancy.