FEATURES OF CEREBRAL PATHOLOGY IN PREGNANT WOMEN: RESULTS OF RETROSPECTIVE CROSS-SECTIONAL STUDY
S.E. Medvedev (1), V.N. Volkova (2), N.N. Volkov (3), M.L. Chukhlovina (1)
1 Almazov National Medical Research Center, St. Petersburg, Russia;
2 St. Petersburg State Pediatric Medical University, St. Petersburg, Russia;
3 City Mariinsky Hospital, St. Petersburg, Russia
Background. In the past decade, worldwide attention has been focused on reducing maternal morbidity and mortality. At the same time, there is an increase in the number of pregnancies against the background of extragenital pathology, among which a special
role is assigned to diseases of the nervous system. Objective: to evaluate the features of the course of cerebral pathology in pregnant women for the expansion of the possibilities of differential diagnosis of various neurological complications during pregnancy.
Methods. Archival medical records of pregnant and puerperant women who were admitted to intensive care units with suspicion of acute neurologic pathology for the period from 2012 to 2016 were analyzed. The study was conducted at the premises of a city multi-field hospital in St. Petersburg. The analysis included 28 case histories. The patient age, gestational age, the final diagnosis, the results of instrumental methods of diagnosis during hospitalization, the results of laboratory methods of examination at admission and at discharge, as well as the blood pressure level of arterial pressure at admission were registered. Results. It was found that the age of patients during the study period ranged from 19 to 46 years. All patients were delivered at gestational age of 28–41 weeks. The structure of neurological pathology during pregnancy was multiform and included encephalopathy, strokes, brain tumors, and epilepsy. The most common cause of hospitalization of pregnant women was mixed encephalopathy. As for laboratory data, it should be noted that the presence of anemia, dyslipidemia, hypoalbuminemia, and hyperfibrinogenemia contributed to the development of neurological complications in pregnant women. Conclusion. Diagnosis of cerebral pathology in pregnant women causes significant difficulties. During pregnancy, particular attention should be paid to the such manifestations as headache, nausea and vomiting, which are considered the first symptoms of the pathology of the nervous system. Neurological complications during pregnancy remain an interdisciplinary problem requiring involvement of such specialists as obstetrician-gynecologist, neurologist, ophthalmologist, therapist and neurosurgeon in diagnostics and treatment.
About the Autors
Corresponding author: S.Е. Medvedev – Postgraduate Student at the Department of Neurology and Psychiatry of the Almazov National Medical Research Center, St. Petersburg, Russia; e-mail: firstname.lastname@example.org