Cerebrovascular diseases and pregnancy
Objective. To study the course of pregnancy and to optimize delivery in women with cerebrovascular diseases.Krasnopolsky V.I., Logutova L.S., Akhvlediani K.N., Travkina A.A., Petrukhin V.A., Lubnin A.Yu., Kheireddin A.S., Budykina T.S., Aksenov A.N., Golovin A.A., Melnikov A.P.
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.
Keywords
pregnancy
stroke
computed tomography
thrombodynamics
cesarean section
fetal vacuum extraction
Supplementary Materials
- Table 1. Extragenital diseases in the examined pregnant women in groups
- Table 2. Complications of pregnancy in the examined patients in groups
- Table 3. Indices of thrombodynamics before and against anticoagulant therapy
- Table 4. Delivery of pregnant women in groups
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Received 03.11.2016
Accepted 11.11.2016
About the Authors
Krasnopolsky Vladislav Ivanovich, academician of the Russian Academy of Sciences, director of the Moscow Regional Research Institute of Obstetrics and Gynecology.101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956235410
Logutova Lidia Sergeevna, doctor of medical sciences, professor, deputy director for science, Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956239835. E-mail: lidia logutova@mail.ru
Akhvlediani Ketevan Nodarievna, Candidate of Medical Science, Senior Researcher of the Physiological Obstetric Department, Moscow Regional Research Institute
of Obstetrics and Gynecology. 101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956230097. E-mail: akhketi@mail.ru
Travkina Arina Andreevna, Candidate of Medical Sciences, Junior Researcher of the Physiological Obstetrics Department, Moscow Regional Research Institute
of Obstetrics and Gynecology. 101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956230397. E-mail: arinamamba@mail.ru
Petrukhin Vasily Alekseevich, doctor of medical sciences, professor, head of the physiological obstetrics department, Moscow Regional Research Institute of Obstetrics and Gynecology. 101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956250852. E-mail: 1akmoniiag@mail.ru
Lubnin Andrey Yurievich, doctor of medical sciences, professor, head of the intensive care unit, Academician N.N. Burdenko Research Institute of Neurosurgery.
125047, Russia, Moscow, 4th Tverskaya-Yamskaya str. 16. E-mail: lubnin@nsi.ru
Kheireddin Ali Sadek, Doctor of Medical Sciences, Leading Researcher of the 3rd Vascular Neurosurgical Department, Academician N.N. Burdenko
Research Institute of Neurosurgery. 125047, Russia, Moscow, 4th Tverskaya-Yamskaya str. 16. E-mail: akheireddin@nsi.ru
Budykina Tatyana Sergeevna, doctor of medical sciences, head of the clinical diagnostic laboratory, Moscow Regional Research Institute of Obstetrics and Gynecology. 101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956232317. E-mail: budit @ mail.
Aksenov A.N., Candidate of Medical Sciences, Head of the Department of Neonatology, Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956230373. E-mail: 1akmoniiag@mail.ru
Golovin A.A., Head of the Department of Anesthesiology and Intensive Therapy, Moscow Regional Research Institute of Obstetrics and Gynecology.
101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956230073. E-mail: zeus61@bk.ru
Melnikov A.P., Candidate of Medical Sciences, Senior Researcher of the Physiological Obstetrics Department, Moscow Regional Research Institute of Obstetrics and Gynecology. 101000, Russia, Moscow, Pokrovka str. 22a. Tel.: +74956230073. E-mail: 1akmoniiag@mail.ru
For citations: Krasnopolsky V.I., Logutova L.S., Akhvlediani K.N., Travkina A.A., Petrukhin V.A., Lubnin A.Yu., Kheireddin A.S., Budykina T.S., Aksenov A.N., Golovin A.A., Melnikov A.P. Cerebrovascular diseases and pregnancy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (8): 50-8. (in Russian)
http://dx.doi.org/10.18565/aig.2017.8.50-8
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