Abstract: Objective To analyze the clinical characteristics of patients with hemorrhagic cerebrovascular disease in late pregnancy and summarize the anesthetic management experience for cesarean delivery. Methods Medical records of patients who underwent lower uterine segment cesarean section for hemorrhagic cerebrovascular disease in late pregnancy at Beijing Tiantan Hospital, Capital Medical University, from January 1, 2020, to January 1, 2025, were retrospectively reviewed. Clinical data, multidisciplinary treatment, anesthetic management, and the outcomes were analyzed. Results Among the 12 patients, 4 (33.3%) underwent emergency cesarean delivery for pregnancy termination, while 8 (66.7%) underwent elective cesarean delivery after expectant management. Neuraxial anesthesia was administered in 10 cases (83.3%), and general anesthesia in 2 cases (16.7%). Except for one case of recurrent cerebral hemorrhage due to delayed neurosurgical intervention, maternal and fetal outcomes were favorable. Conclusions Multidisciplinary collaboration is essential for management of late-pregnancy patients with hemorrhagic cerebrovascular disease. Anesthetic management should extend beyond the intraoperative period of cesarean delivery, emphasizing comprehensive monitoring throughout the perinatal and postpartum periods.

Key words: pregnancy, anesthesia, cerebrovascular malformation, cerebral hemorrhage