{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:27:56Z","timestamp":1787272076228,"version":"build-2736575974"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Objective Moyamoya disease is a rare progressive cerebrovascular disorder characterized by stenosis of the intracranial internal carotid arteries and formation of fragile collateral vessels, predisposing patients to ischemic and hemorrhagic stroke. Physiologic changes of pregnancy\u2014including increased blood volume, systemic vasodilation, and augmented cerebral blood flow\u2014may increase cerebrovascular vulnerability and complicate management.<\/jats:p>\n                  <jats:p>Study Design We describe three pregnancies complicated by moyamoya disease managed at a tertiary referral center in West Texas. All patients had undergone prior cerebral revascularization and were followed by neurology before conception. Antithrombotic strategies varied by individual risk factors and included aspirin or low-molecular-weight heparin. Comorbidities included pregestational diabetes with dichorionic diamniotic twins, homozygous factor V Leiden, and Chiari malformation with MTHFR mutation.<\/jats:p>\n                  <jats:p>Results Two patients underwent planned cesarean delivery with favorable maternal and neonatal outcomes following multidisciplinary management. The third developed preeclampsia with severe features at 32 weeks and experienced sudden neurologic deterioration. Despite emergent cesarean delivery, she suffered a fatal intracerebral hemorrhage.<\/jats:p>\n                  <jats:p>Conclusion These cases highlight the spectrum of pregnancy outcomes in patients with moyamoya disease and emphasize the importance of multidisciplinary care, strict blood pressure control, and careful neurologic surveillance.<\/jats:p>","DOI":"10.1055\/a-2930-3966","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:08:16Z","timestamp":1787270896000},"page":"e148-e151","source":"Crossref","is-referenced-by-count":0,"title":["Moyamoya Disease in Pregnancy: A Case Series"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8186-9249","authenticated-orcid":false,"given":"Hannah Elizabeth","family":"McCool","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center, Texas, United States","place":["Lubbock"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Cochran","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center, Texas, United States","place":["Lubbock"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri","family":"Spontarelli Fruit","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center School of Medicine, Texas, United States","place":["Lubbock"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bill","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center, Texas, United States","place":["Lubbock"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1007\/s00701-018-3597-6","article-title":"Moyamoya disease in pregnancy: a systematic review","volume":"160","author":"G A Maragkos","year":"2018","journal-title":"Acta Neurochir"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"793","DOI":"10.3349\/ymj.2015.56.3.793","article-title":"Pregnancy outcomes in women with moyamoya disease: experiences at a single center in Korea","volume":"56","author":"Y J Jung","year":"2015","journal-title":"Yonsei Med J"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"10","DOI":"10.3171\/2019.8.JNS191372","article-title":"Pregnancy after direct cerebral bypass for moyamoya disease","volume":"134","author":"E W Church","year":"2019","journal-title":"J Neurosurg"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1258\/om.2011.110046","article-title":"Moyamoya disease in pregnancy: maintenance of maternal blood pressure","volume":"5","author":"H L Barrett","year":"2012","journal-title":"Obstet Med"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.tjog.2023.03.017","article-title":"Safe delivery planning of patients with moyamoya disease in pregnancy: case series of a single center","volume":"62","author":"J Kang","year":"2023","journal-title":"Taiwan J Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e391","DOI":"10.1016\/j.wneu.2022.03.135","article-title":"Arterial ischemic stroke in moyamoya patients who underwent vaginal delivery and cesarean section","volume":"163","author":"A M Antoniazzi","year":"2022","journal-title":"World Neurosurg"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/23969873221144089","article-title":"European stroke organisation (ESO) guidelines on moyamoya angiopathy endorsed by vascular European reference network (VASCERN)","volume":"8","author":"A Bersano","year":"2023","journal-title":"Eur Stroke J"},{"issue":"16","key":"ref8","doi-asserted-by":"crossref","first-page":"3628","DOI":"10.3390\/jcm10163628","article-title":"Clinical management of moyamoya patients","volume":"10","author":"I Canavero","year":"2021","journal-title":"J Clin Med"}],"container-title":["American Journal of Perinatology Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2930-3966.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:08:18Z","timestamp":1787270898000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2930-3966"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":8,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,7,31]]},"published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2930-3966","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2157-6998","2157-7005"],"issn-type":[{"value":"2157-6998","type":"print"},{"value":"2157-7005","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}