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Moya MoyaFrom: Allan Fisher (fisheraj@UMDNJ.EDU)Fri Oct 3 15:39:37 1997
Well, do I have a case.... We were consulted on a patient who may have Moya Moya disease. Though her diagnosis is not 100%. She also happens to have antiphospholipid syndrome with a positve ANA, RF, ACL, and SSA. Her history includes a "TIA" three years ago while on BCPs for three months. No problems since her being off the oral contraceptives. She is on LDASA for now and is 10 weeks pregnant. Moya moya patients, if you don't recall, bleed in their head which can occur at any time. She is now 29 yo, a prim and Chinese. This disease is endemic to Asians, especially the Japanese. This is a new diagnosis for her and thus the surgery usually required to help has not been performed. The extent of her disease is not well described yet also. She has seen the Moya Moya guru in NY at Columbia already who thinks that she has the Dz and says she is "moderately" affected. There is VERY little English-written cases in pregnancy for Moya Moya. We can use some help with those who have had a larger experience then our three. The neurologist wants us to do an elective cesarean; we will probably perform an operative vaginal delivery and do a cesarean for obstetric reasons only. The Question: Heparin? Full dose or prophylaxis? I will be out of town in Baltimore for a conference (need to study for the Boards) for the week but please feel free to talk re the case without me. It is good to be back (for those who remember me). I have had a year hiatus to ob-gyn-l. I think I am getting settled now here in NJ! Allan
-- Allan J. Fisher, MD, FACMG Assistant Professor of Clinical Obstetrics and Gynecology Director of Genetic Perinatology Division of Maternal-Fetal Medicine Department of Obstetrics, Gynecology and Reporductive Sciences UMDNJ-RWMS/St. Peter's Medical Center 254 Easton Avenue, MOB 4th Floor New Brunswick, NJ 08903-0591
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