DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204320

A study of neurological disorders in pregnancy and puerperium

Megha Gupta, Yashodhara Pradeep, Renu Singh, P. K. Shrivastava

Abstract


Background: Neurological diseases contribute to 20% of maternal deaths. The objective of this study was to find the prevalence of primary and secondary neurological disorders in pregnant and postpartum patients, to study their clinical features, feto-maternal outcome and diagnosis using radiological imaging.

Methods: This is a prospective cross-sectional study done over a period of 1 year. Pregnant and postpartum women with neurological disorders except eclampsia were enrolled. A total of 100 cases were analysed out of which 92 underwent radiological imaging to confirm diagnosis. Primary outcome in the form of prevalence of neurological disorders and secondary outcome in the form of maternal and foetal outcome was assessed.

Results: The prevalence of neurological disorders in pregnancy is 1150/100000 deliveries. 75 cases were classified as primary neurological disorders (prevalence of 862/100000) which included epilepsy, cerebrovascular accidents, CNS infections, neoplasm, neuropathies and miscellaneous. 25 cases were secondary neurological disorders (prevalence of 287/100000) which included hepatic and septic encephalopathy. Among primary disorders the prevalence of cerebrovascular accidents was found to be highest (33.3%) followed by epilepsy (32%) while that among secondary neurological disorder was of Hepatic encephalopathy (92%). Majority (68%) had recovery while 15%of women had residual deficit. There were 17 (17%) cases of maternal mortality.

Conclusions: Neurological disorders were significantly associated with poor feto- maternal outcome. Radiological imaging in the form of MRI is an excellent diagnostic tool for confirming diagnosis of neurological disorders.


Keywords


cerebrovascular accident; epilepsy; neurological disorder

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References


Berg CJ, Chang J, WM, Whitehead SJ. Pregnancy-related mortality in the united states, 1991-1997. Obstet Gynecol 2003;101(2):289–96.

Gupta S, A Rohtagi, SK Sharma, Gurtoo A. A study of neurological disorders during pregnancy and puerperium. Ann Indian Acad Neurol 2006;9(3);152 –7.

World Health Organization. [accessed on April 2013]; Headache disorders. http://www.who.int/mediacentre/factsheets/fs277/en/

Fox MW, Harms RW, Davis DH. Selected neurologic complications of pregnancy. Mayo Clin Proc 1990;65(12):1595–618.

Kriplani A, Relan S, Misra NK, Mehta VS, Takkar D. Ruptured intracranial aneurysm complicating pregnancy. Int J Gynaecol Obstet 1995;48(2):201-6.

Cantu C, Barinagarrementeria F. Cerebral venous thrombosis associated with pregnancy and Puerperium. Review of 67 cases. Stroke 1993;24(12):1880–4.

Hilsinger RL Jr, Adour KK, Doty HE. Idiopathic facial paralysis, pregnancy, and the menstrual cycle. Ann Otol Rhinol Laryngol 1975;84(4 Pt 1):433-42.

To WK, Cheung RT. Neurological disorders in pregnancy. Hongkong Med J 1997;3(4):400-8.

Janaki S, Thomas L. Neurological complications in pregnancy and puerperium. J Assosc Phys India 1963;11:128-37.

Agarwal K. Neurological disorders in pregnancy and puerperium. J Assoc Phys India 1968;19:705-13.

Srinivasan K, Ramamurthi B. Neurological disorders in pregnancy and puerperium. J Assoc Phys India 1971;19(10):705-13.

Amias AG. Cerebral vascular disease in pregnancy, I: haemorrhage. J Obstet Gynaecol Br Commonw. 1970;77:100-12 39Me Eur J Neurol 2006;13(11):1256-60.

Chandrasekara S, Anand JP, Nanjundan M, Natarajan S, Ramadhas K. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2016:15(4):62-8.

Jeng JS, Tang SC, Yip PK. Stroke in women of reproductive age :comparison between stroke related and unrelated to pregnancy J Neurol Sci 2004; 221(1-2):25-9.