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Cerebrovascular disorders complicating pregnancy--beyond eclampsia
A G Witlin1, S A Friedman, R S Egerman
1Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
American Journal of Obstetrics and Gynecology
|June 1, 1997
Summary
Cerebrovascular disorders during pregnancy are rare but dangerous, leading to significant maternal and fetal mortality. Prompt neuroimaging is crucial for suspected eclampsia unresponsive to treatment.
Area of Science:
- Neurology
- Obstetrics
- Vascular Medicine
Background:
- Cerebrovascular disorders are uncommon yet serious complications during pregnancy and the postpartum period.
- These conditions pose substantial risks to both maternal and fetal well-being.
Purpose of the Study:
- To investigate challenges in diagnosing and managing cerebrovascular disorders in pregnant and postpartum women.
- To identify factors influencing maternal and fetal outcomes.
Main Methods:
- Retrospective chart review of pregnancies complicated by cerebrovascular disorders between 1985 and 1995.
- Exclusion of cases related to trauma, tumors, drug use, and infections.
Main Results:
- The study included 24 women with various cerebrovascular conditions, including infarction, intracranial hemorrhage, and hypertensive encephalopathy.
- Delayed diagnosis was common, with presumed eclampsia hindering identification in 41.7% of cases.
- Maternal mortality was high at 29.2%, with no adverse outcomes deemed preventable by earlier medical intervention.
Conclusions:
- Cerebrovascular disorders in pregnancy are unpredictable and associated with high mortality.
- Neuroimaging is recommended for suspected eclampsia unresponsive to magnesium sulfate.
- Severe hypertension was not a consistent predictor of intracranial hemorrhage in this cohort.