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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Intracranial hemorrhage in pregnancy
Afshan B Hameed1, Vineet K Shrivastava, Lisa Blair
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California-Irvine Medical Center, Orange, California.
AJP Reports
|August 16, 2013
Summary
A pregnant woman on anticoagulation for a mechanical mitral valve developed a rare subdural hematoma. Prompt multidisciplinary care led to resolution of her intracranial abnormality and a healthy delivery.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Neurology
Background:
- Management of anticoagulation in pregnant women with mechanical prosthetic valves is complex.
- Anticoagulant therapy requires careful balancing of risks, including thromboembolism and bleeding.
- Mechanical prosthetic valves necessitate anticoagulation throughout pregnancy.
Observation:
- A pregnant patient with a mechanical mitral valve received sequential anticoagulation: low-molecular-weight heparin, then warfarin, then unfractionated heparin.
- The patient developed a severe headache, diagnosed as a large subdural hematoma with midline shift.
- The subdural hematoma occurred during a transition to intravenous unfractionated heparin for regional anesthesia.
Findings:
- Subdural hematoma is a rare but serious complication in pregnant patients on anticoagulation.
- The patient successfully delivered a healthy infant via cesarean section.
- Conservative management led to the resolution of the subdural hematoma and neurological symptoms.
Implications:
- This case highlights the importance of vigilant monitoring for neurological complications in pregnant patients on anticoagulation.
- Multidisciplinary management involving obstetrics, cardiology, and neurology is crucial for optimizing outcomes.
- Careful consideration of anticoagulation strategies and timing is essential to mitigate bleeding risks during pregnancy and delivery.
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