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Stroke complicating pregnancy and the puerperium
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|March 4, 1999
Summary
Stroke during pregnancy and postpartum significantly increases maternal mortality and morbidity. Prompt diagnosis and management are crucial for improving outcomes in these high-risk pregnancies.
Area of Science:
- Neurology
- Obstetrics & Gynecology
- Public Health
Background:
- Nonobstetric complications, particularly stroke, are increasingly significant in maternal mortality as obstetric deaths decline.
- Stroke during pregnancy and the postpartum period presents severe risks for maternal morbidity and mortality.
- Understanding stroke's impact is vital for improving maternal care.
Purpose of the Study:
- To investigate maternal outcomes for women experiencing stroke during pregnancy and the postpartum period.
- To review the causes, incidence, and essential management strategies for stroke in this population.
Main Methods:
- A 10-year retrospective study (1986-1996) identified women with stroke during pregnancy or up to six weeks postpartum.
- Stroke was defined as a focal neurologic syndrome (hemorrhagic or ischemic) confirmed by neuroimaging.
- Cases were reviewed by neurologists using medical records.
Main Results:
- Thirteen cases of stroke were identified, with 9 hemorrhagic and 4 ischemic strokes.
- The incidence of stroke was approximately 1 in 6,500 pregnancies.
- Stroke resulted in 38% mortality, and 63% of survivors experienced residual neurologic deficits; 46% of strokes occurred postpartum.
Conclusions:
- Stroke during pregnancy and puerperium is associated with high mortality and morbidity.
- Early diagnosis and adequate, prompt management are essential for favorable maternal outcomes.
- Continuous, meticulous care throughout the antepartum, intrapartum, and postpartum periods is recommended.