Clinical Analysis Of 15 Cases Of Stroke Related To Pregnancy

Objective: This study aimed to analysis the epidemiology, risk factors, diagnosis and treatment of stroke related to pregnancy.Methods: Patients with stroke during pregnancy or within 6 weeks of delivery were reviewed, who were recruited in the neurology department of our hospital from January 1^st 2000 to December 31^st 2007.Stroke related pregnancy was classified as ischemic stroke and hemorrhagic stroke. Ischemic strokes include cerebral vascular thrombosis and cerebral embolism, and hemorrhagic strokes include cerebral hemorrhage and subarachnoid hemorrhage. All cases were diagnosed by CT or MRI scan.Results: 15 patients with diagnosis of stroke related to pregnancy were identified, including 10 patients with ischemic stroke and 5 with hemorrhagic stroke. Ischemic stroke cases included 8 with cerebral infarction and 2 with superior sagittal sinus thromboses; hemorrhagic stroke cases include 4 with cerebral hemorrhage and 1 with subarachnoid hemorrhage. There were 4 with high blood viscosity level, 6 with high blood fat level, 4 with high fibrinogen level,4 with gestational hypertension disease, 3 after caesarean section,3 with infections, 1 with antiphospholipid syndrome, 1 with rheumatic disease of the heart and 1with cerebral arteriovenous malformation. 10 patients discharged with conservative treatment. 1 patient had to accept caesarean section followed by evacuation of intracranial hematoma, and another patient accepted caesarean section under general anesthesia. 1 case with AVM received treatment of surgical intervention. Only one with massive infarction died of cerebral hernia. 1 with APS discharged to another hospital.Conclusion: Stroke related to pregnancy which threatens the lives of mother andfetus, has a proportion of 13.2% in stroke of young women. A state ofhypercoagulability and some complications during pregnancy may play an importantrole on the inducement and deterioration of stroke. When neurologic signs andsymptoms appear in pregnant women, neuroimaging such as CT and MRI isrecommended for identification of the disease. Frequently, it needs closecooperation of the internist, surgeon and obstetrician for diagnosis and treatment.Most patients had good result.