Intracranial Hemorrhage in a Pregnant Woman on Low-Dose Aspirin: A Case Report

BACKGROUND Preeclampsia is a risk factor for maternal intracranial hemorrhage (ICH). Low-dose aspirin is used to prevent preeclampsia. This report describes the case of a 32-year-old pregnant woman taking 100 mg aspirin daily after 12 weeks of gestation who developed cerebral hemorrhage and intraventricular hemorrhage at 33 weeks 5 days of gestation. CASE REPORT We report the case of a 32-year-old pregnant woman with multiple risk factors for preeclampsia, including obesity, as well as personal history factors (adverse pregnancy outcome, history of hydatidiform mole). She began taking aspirin 100 mg daily to prevent preeclampsia after 12 weeks of gestation. She had regular obstetric examinations and was free of gestational hypertension and other diseases. At 33 weeks 5 days of gestation, she suddenly developed a severe headache followed by vomiting, confusion, and clammy limbs. She denied any head trauma and was transferred to our hospital from a nearby hospital. Emergency CT showed cerebral hemorrhage in the left frontal lobe breaking into the ventricular system. After multidisciplinary discussion, an emergency cesarean section was performed to rescue the fetus and the ICH was treated conservatively. Both the newborn and mother recovered well. CONCLUSIONS The occurrence of cerebral hemorrhage and intraventricular hemorrhage in pregnant women who take aspirin daily is a very rare event that seriously threatens the life and safety of mother and child. Computed tomography helps with diagnosis, and such cases require multidisciplinary team support, timely cesarean section to save the fetus, and individualized treatment of ICH.