Cerebrovascular diseases and pregnancy


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Abstract

Objective. To study the course of pregnancy and to optimize delivery in women with cerebrovascular diseases. Subjects and methods. A total of 102 pregnant women aged 17 to 42 years with cerebrovascular diseases (CVD) (strokes) were followed up. In 25 of them, stroke occurred during this pregnancy. All the women underwent general clinical examination, hemostatic study, ultrasound and instrumental techniques, and consultations by a neurologist, a neurosurgeon, and an anesthesiologist. Results. After the examination, a delivery plan was consultatively elaborated: 47 (46.1%) pregnant women delivered a baby via cesarean delivery, 55 (53.9%) had vaginal deliveries, including obstetrical forceps and fetal vacuum extraction ones in 3 (2.9%) in 16 (15.7%) cases, respectively. 104 babies (two twins) were born; 97 (93.3%) infants were satisfactorily discharged home together with their mothers; 7 (6.7%), including four of the twins and other three babies after a premature birth, were transferred to the second nursing step. There were no maternal and perinatal deaths. Conclusion. Successful treatment and adequate management of pregnancy in this group of patients depends on the clear interaction of obstetricians/gynecologists, neurologists, neurosurgeons, anesthesiologists, and neonatologists. To optimize the management of pregnant women with CVD with the participation of a group of specialists makes it possible to safely increase the frequency of vaginal delivery in these patients.

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About the authors

Vladislav Ivanovich Krasnopolsky

Moscow Regional Research Institute of Obstetrics and Gynecology

academician of the Russian Academy of Sciences, director

Lidia Sergeevna Logutova

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: lidia.logutova@mail.ru
doctor of medical sciences, professor, deputy director for science

Ketevan Nodarievna Akhvlediani

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: akhketi@mail.ru
Candidate of Medical Science, Senior Researcher of the Physiological Obstetric Department

Arina Andreevna Travkina

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: arinamamba@mail.ru
Candidate of Medical Sciences, Junior Researcher of the Physiological Obstetrics Department

Vasily Alekseevich Petrukhin

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: lakmoniiag@mail.ru
doctor of medical sciences, professor, head of the physiological obstetrics department

Andrey Yurievich Lubnin

Academician N.N. Burdenko Research Institute of Neurosurgery

Email: lubnin@nsi.ru
doctor of medical sciences, professor, head of the intensive care unit

Ali Sadek Kheireddin

Academician N.N. Burdenko Research Institute of Neurosurgery

Email: akheireddin@nsi.ru
Doctor of Medical Sciences, Leading Researcher of the 3rd Vascular Neurosurgical Department

Tatyana Sergeevna Budykina

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: budit@mail
doctor of medical sciences, head of the clinical diagnostic laboratory

A. N Aksenov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: lakmoniiag@mail.ru
Candidate of Medical Sciences, Head of the Department of Neonatology

A. A Golovin

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: zeus61@bk.ru
Head of the Department of Anesthesiology and Intensive Therapy

A. P Melnikov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: lakmoniiag@mail.ru
Candidate of Medical Sciences, Senior Researcher of the Physiological Obstetrics Department

References

  1. Kuklina E.V., Tong X., Bansil P., George M.G., Callaghan W.M. Trends in pregnancy hospitalizations that included a stroke in the United States from 1994 to 2007: reasons for concern? Stroke. 2011; 42(9): 2564-70.
  2. Tettenborh B. Stroke and pregnancy. Neurol. Clin. 2012; 30(3): 913-24.
  3. Lamy C. Stroke during the pregnancy and the puerperium. Rev. Prat. 2013; 63(7): 933-5.
  4. Grear K.E., Bushnell C.D. Stroke and pregnancy: clinical presentation, evaluation, treatment, and epidemiology. Clin. Obstet. Gynecol. 2013; 56(2): 350-9.
  5. Khan M., Wasay M. Haemorrhagic strokes in pregnancy and puerperium. Int. J. Stroke. 2013; 8(4): 265-72.
  6. Ласков В.Б. Факторы риска, механизмы развития и виды инсульта при беременности. Возможности медикаментозной терапии. Неврология, нейропсихиатрия, психосоматика. 2013; 3: 71-7. [Laskov V.B. Risk factors, mechanisms of development and types of stroke during pregnancy. Possibilities of drug therapy. Nevrologiya, neyropsihiatriya, psihosomatika. 2013; (3): 71-7. (in Russian)]
  7. Tate J., Bushnell C. Pregnancy and stroke risk in women. Womens Health (Lond). 2011; 7(3): 363-74.
  8. Moatti Z., Gupta M., Yadava R., Thamban S. A review of stroke and pregnancy: incidence, management and prevention. Eur. J. Obstet. Gynecol. Reprod. Biol. 2014; 181: 20-7.
  9. Макацария А.Д., Акиньшина С.В., Бицадзе В.О. Беременность у женщин с криптогенным ишемическим инсультом в анамнезе. Практическая медицина. 2012; 9: 12-5. [Makatsaria A.D., Akinshina S.V., Bitsadze V.O. Pregnancy in women with cryptogenic ischemic stroke in anamnesis. Prakticheskaya meditsina. 2012; 9: 12-5. (in Russian)]
  10. Латышева В.Я., Курман В.И., Быченко М.П. Этиологические факторы развития мозгового инсульта у беременных (обзор литературы). Международный неврологический журнал. 2010; 5: 18-23. [Latysheva V.Ya., Kurman V.I., Bychenko M.P. Etiological factors in the development of stroke in pregnant women (review). International neurological journal. 2010; (5): 18-23. (in Russian)]
  11. Takahashi J.C., Iihara K., Ishii A., Watanade E., Ikeda T., Miyamoto S. Pregnancy-associated intracranial hemorrhage: results of a survey of neurosurgical institutes across Japan. J. Stroke Cerebrovasc. Dis. 2014; 23(2): e65-71.
  12. Cheng S.J., Chen P.H., Chen L.A., Chen C.P. Stroke during pregnancy and puerperium: clinical perspective. Taiwan J. Obstet. Gynecol. 2010; 49(4): 395-400.
  13. Rouach S., Bettermann K., Biller J. Toole’s cerebrovascular disorders. 6th ed. Cambridge University Press; 2010: 333-44.
  14. Gorgui J., Gorshkov M., Khan N., Daskalopoulou S.S. Hypertension as a risk factor for ischemic stroke in women. Can. J. Cardiol. 2014; 30(7): 774-82.
  15. Kataoka H., Miyoshi T., Neki R., Yoshimatsu J., Ishibashi-Ueda H., Iihara K. Subarachnoid hemorrhage from intracranial aneurysms during pregnancy and the puerperium. Neurol. Med. Chir.(Tokyo). 2013; 53(8): 549-54.
  16. Kim K.D., Chang C.H., Choi B.Y., Jung Y.J. Endovascular treatment of a ruptured posterior inferior cerebellar artery aneurysm during pregnancy. J. Korean Neurosurg. Soc. 2014; 55(5): 273-6.

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