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Pregnancy in CADASIL.

I Donnini1, V Rinnoci1, S Nannucci1,2

  • 1NEUROFARBA Department, University of Florence, Florence, Italy.

Acta Neurologica Scandinavica
|June 14, 2017
PubMed
Summary
This summary is machine-generated.

Pregnancy in women with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) appears safe. The study found no increased risk of vascular events or adverse fetal outcomes, suggesting routine antithrombotic treatment is unnecessary.

Keywords:
CADASILantithrombotic treatmentmiscarriagepregnancyprognosis

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Area of Science:

  • Neurology
  • Genetics
  • Obstetrics

Background:

  • Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic small vessel disease.
  • Women with CADASIL are often advised against pregnancy due to perceived risks and prescribed antithrombotic drugs.
  • Limited data exists on pregnancy outcomes in CADASIL patients.

Purpose of the Study:

  • To evaluate pregnancy outcomes in women with CADASIL.
  • To assess the safety of pregnancy for both CADASIL patients and their fetuses.
  • To determine the necessity of prophylactic antithrombotic treatment during pregnancy.

Main Methods:

  • Retrospective review of 50 female CADASIL patients.
  • Prospective data collection on six patients, totaling 93 pregnancies.
  • Analysis of maternal and fetal outcomes, including vascular events, miscarriages, births, and gestational complications.

Main Results:

  • No maternal onset of CADASIL or cerebral ischemic events occurred during pregnancy.
  • 17.2% miscarriage rate; 72 vaginal births and 5 cesarean sections.
  • Fetal growth and newborn weights were comparable to the general population; mild gestational complications observed in two patients.

Conclusions:

  • Pregnancy in CADASIL patients does not appear to be associated with adverse outcomes for mother or fetus.
  • There is no evidence to support routine prophylactic antithrombotic treatment during pregnancy for CADASIL.
  • Physicians and patients can be reassured about the safety of initiating pregnancy in CADASIL, pending larger studies.