Intracerebral and subarachnoid hemorrhage in pregnancy

Jason Liew, James Feghali, Judy Huang

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Maternal stroke occurs in around 34 out of every 100,000 deliveries and is responsible for around 5%–12% of all maternal deaths. It is most commonly hemorrhagic, and women are at highest risk for developing pregnancy-related hemorrhage during the early postpartum period through 6 weeks following the delivery. The most common causes of hemorrhagic stroke in pregnant patients are arteriovenous malformations and cerebral aneurysms. Management is similar to that for acute hemorrhagic stroke in the nonpregnant population with standard use of computed tomography and judicious utilization of intracranial vessel imaging and contrast. The optimal delivery method is evaluated on a case-by-case basis, and cesarean delivery is not always required. As most current studies are limited by retrospective design, relatively small sample sizes, and heterogeneous study term definitions, strong and comprehensive evidence-based guidelines on the management of acute hemorrhagic stroke in pregnant patients are still lacking. In the future, multicenter registries and prospective studies with uniform definitions will help improve management strategies in this complex patient population.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages33-50
Number of pages18
DOIs
StatePublished - 2020

Publication series

NameHandbook of Clinical Neurology
Volume172
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Keywords

  • Intracranial hemorrhage
  • Pregnancy
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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