Arteriovenous Malformations in Pregnancy—Report of Two Patients

Abstract Cerebral arteriovenous malformations (AVMs) during pregnancy pose significant risks of hemorrhage, requiring careful multidisciplinary management. The optimal anesthetic and obstetric strategies remain unclear due to limited data. We report two cases of pregnant women with cerebral AVMs managed by a multidisciplinary team. Both patients underwent close neurological and fetal monitoring and elective cesarean deliveries under spinal anesthesia combined with norepinephrine infusion to maintain hemodynamic stability. The first case involved a primigravida with a large, unruptured right parietal AVM presenting with headache and transient visual symptoms. The second was a secundigravida presenting with seizures and subacute hemorrhages. Both deliveries were uneventful, with stable mean arterial pressures maintained intraoperatively, no hypertensive surges, and favorable maternal and neonatal outcomes. Postpartum plans included further neurovascular evaluation. These cases highlight the importance of individualized, multidisciplinary care in managing cerebral AVMs during pregnancy. Spinal anesthesia with norepinephrine infusion provided stable hemodynamic control and allowed continuous neurological monitoring, potentially reducing rupture risk. Further research is needed to establish standardized protocols.