A clinical case of the course of pregnancy and childbirth in a female patient with chronic demyelinating polyneuropathy, frontal lobe meningioma, and single kidney

Background: Extragenital pathology is now becoming one of the main causes of maternal mortality in the Russian Federation. The introduction of clinical protocols and guidelines is aimed at changing the situation. The established practice imposes responsibility on an obstetrician/gynecologist for the course and outcomes of pregnancy and childbirth, and therefore the obstetricians/gynecologists need to have a broader clinical outlook, by constantly improving their knowledge. One of the serious challenges is comorbidity that is a combination of a number of diseases, each of which individually can play a decisive role in shaping the outcome of childbirth. The description of a clinical case of a rare combination of extragenital diseases will, in our opinion, serve as a good addition to the education of obstetricians/gynecologists. Chronic inflammatory demyelinating polyneuropathy (CIDP), convexity meningioma, and the absence of a kidney, all together are a risk for premature birth and a complication during and after pregnancy. Case report: The paper describes a clinical case of patient management from of pregravid preparation, during pregnancy and childbirth to the postpartum period with a combination of diseases, such as CIDP, convexity meningioma of the frontal lobe, and a single kidney, which had clinical manifestations as decreased vibration sensitivity in the lower extremities and as gait with ataxic elements. The growth of meningioma and the functional state of a single kidney were monitored throughout the pregnancy. The decision to present the clinical case is due to a rare combination of the above diseases in one individual. Conclusion: Patients with concomitant extragenital diseases constitute a main risk group for unfavorable perinatal outcomes. Unfortunately, there are presently no clinical guidelines for each ICD-10 code. The only correct strategy for managing these patients is appropriate pregravid training, a joint follow-up with physicians of related specialties throughout the gestation period. Adequate organization of perinatal monitoring determines the possibility of prolonging pregnancy and the birth of a healthy baby.

meningioma, single kidney, high-risk pregnancy, concomitant extragenital pathology