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Neurologic disorders in pregnancy.

Dilip R Karnad1, Kalpalatha K Guntupalli

  • 1Medical-Neuro-Intensive Care Unit, Department of Medicine, Seth G. S. Medical College and King Edward Memorial Hospital (DRK), Mumbai, India.

Critical Care Medicine
|October 11, 2005
PubMed
Summary

Critical neurologic conditions in pregnancy, including eclampsia and brain tumors, require careful management considering fetal impact. Prompt delivery can be life-saving for mother and fetus in severe cases.

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Area of Science:

  • Neurology
  • Obstetrics
  • Critical Care Medicine

Background:

  • Neurologic dysfunction, coma, and seizures are frequent complications in critically ill obstetric patients.
  • These conditions necessitate a thorough understanding of associated obstetric and neurologic disorders.

Purpose of the Study:

  • To review common neurologic disorders leading to critical illness in pregnant patients.
  • To highlight diagnostic challenges and management considerations for these conditions.

Main Methods:

  • Review of obstetric disorders causing coma and seizures, including eclampsia, acute fatty liver of pregnancy, and amniotic fluid embolism.
  • Examination of pre-existing neurologic conditions, vascular abnormalities, infections, and tumors during pregnancy and postpartum.
  • Analysis of conditions causing respiratory failure and demyelinating diseases.

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Main Results:

  • Eclampsia, acute fatty liver of pregnancy, and amniotic fluid embolism are key obstetric causes of coma and seizures.
  • Pregnancy exacerbates risks for epilepsy, aneurysms, arteriovenous malformations, and brain tumors.
  • Infections like cerebral malaria and hepatic failure, alongside conditions like cerebral venous sinus thrombosis and myasthenic crisis, are significant contributors to critical neurologic illness.

Conclusions:

  • Management decisions must prioritize the well-being of both mother and fetus.
  • Prompt delivery is often critical in conditions like eclampsia and acute fatty liver of pregnancy.
  • Expectant management may be suitable for other obstetric neurologic emergencies.