Selected Neurologic Complications of Pregnancy

Fox, Mark; Harms, Roger W.; Davis, D. H.

doi:10.1016/s0025-6196(12)62195-8

Cited by 70 publications

(24 citation statements)

References 124 publications

(38 reference statements)

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“…21 Another study based its conclusion on the high numbers of observed and published patients with SAH during pregnancy, but lacked a proper control group. 2 Although we found no instances of aSAH during delivery in our series, such patients have been reported, 13,15 but rarely. In a nationwide Swedish study encompassing over 1 000 000 deliveries, 8 instances of SAH were found during delivery.…”

Section: Discussioncontrasting

confidence: 51%

“…12 It remains unclear whether the risk of aSAH is increased during the period of pregnancy, delivery, and the puerperium. Some have suggested that the risk of SAH during pregnancy, delivery, or the puerperium is higher than outside this period, [13][14][15] whereas others concluded that rupture of an aneurysm is not more common during pregnancy than at other times. 16 An increased tendency of aSAH with advancing gestational age has been suggested and related to the hemodynamic changes that occur during the course of pregnancy.…”

mentioning

confidence: 99%

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The Risk of Aneurysmal Subarachnoid Hemorrhage During Pregnancy, Delivery, and the Puerperium in the Utrecht Population

Groenestege

Rinkel

Bom

et al. 2009

Stroke

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Background and Purpose-It is unclear whether the risk of aneurysmal subarachnoid hemorrhage (aSAH) is increased during pregnancy, labor, and the puerperium. We compared the risk of aSAH during this period with the risk outside this period. Methods-We included women with aSAH between 18 and 42 years of age (nϭ244) from our prospectively collected database of patients with subarachnoid hemorrhage treated in the University Medical Center Utrecht, the provincial referral center, between January 1987 and April 2006. We estimated the relative risk of aSAH during pregnancy, delivery, or the puerperium by a case-crossover design and calculated a standardized incidence ratio, dividing the observed number of patients with aSAH during pregnancy, delivery, or puerperium by the expected number based on the incidence in the general population of women of the same age during the study period. Results-Of the 244 women, 4 were pregnant, 3 in the puerperium and none in labor. The relative risk of aSAH during pregnancy, delivery, or the puerperium was 0.4 (95% CI, 0.2 to 0.9). Based on the number of women aged 18 to 42 years within the catchment area of our hospital and the number of pregnancies within the study period, the expected number of patients with aSAH during pregnancy, delivery, or the puerperium was 12, resulting in a standardized incidence ratio of 0.6 (95% CI, 0.2 to 1.1). Conclusions-The risk of aSAH is not increased during pregnancy, labor, and the puerperium. There is no need to advise against pregnancy in women with an increased risk of subarachnoid hemorrhage and no evidence to advise against vaginal delivery in such women.

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Section: Discussioncontrasting

confidence: 51%

mentioning

confidence: 99%

The Risk of Aneurysmal Subarachnoid Hemorrhage During Pregnancy, Delivery, and the Puerperium in the Utrecht Population

Groenestege

Rinkel

Bom

et al. 2009

Stroke

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“…7 The ocular findings in eclampsia are fairly common and they are those of hypertensive retinopathy. 2 However, the cerebral complications are not as common, and less common is reversible cortical blindness following eclampsia.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Total Loss of Vision Following Eclampsia: A Case Report

Waziri-Erameh

Omoti

Edema

2003

African Journal of Reproductive Health

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Visual loss following eclampsia is usually reported to be a result of retinopathy, exudative retinal detachment or cortical blindness. This paper reports the case of a 31-year-old para 5 + 0 housewife who developed bilateral visual loss following eclampsia and presented to the ophthalmologist four weeks later with a vision of light perception in both eyes. Examination showed evidence of hypertensive retinopathy. Convinced that the ocular findings were not responsible for such marked visual loss, she was commenced on systemic, topical and sub-conjunctival injection of steroids, acetazolamide and multivitamins. Her vision improved progressively to 6/6 right eye and 6/9 left eye after three weeks. Obstetricians are advised to refer cases of visual loss following eclampsia promptly to the ophthalmologist who should in turn manage aggressively with systemic, topical and sub-conjunctival steroids. (Afr J Reprod Health 2003; 7[2]: 106-108) RÉSUMÉ

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“…The risk of subarachnoid hemorrhage in pregnant women is five times that in nonpregnant women, with the most common causes being rupture of an aneurysm on arteniovenous malformation [3]. estrogen receptors have been shown in a small number of gliomas [4].…”

Section: Intracranial Hemorrhagementioning

confidence: 99%