Stroke in pregnancy, causes, diagnosis, risk factors
When the blood supply to a part of brain is hampered for any
reason, the clinical condition that it causes is known as stroke.
If we compare similar age groups, women who are pregnant or
have just had a delivery are more prone for stroke then their non pregnant
counterpart.
Patients with stroke may present with sudden onset severe
headache, one side paralysis, fits, first episode migraine and other
neurological deficits.
Many a times decreased blood supply is transient and
reversible and symptoms recover within 24 hours. This clinical entity is known
as transient ischemic attack. Ischemia means less blood supply.
If a pregnant woman presents with stroke, then MRI and
angiography of brain and 2D ECHO are done to arrive at diagnosis and to know
the probable cause.
In blood, Anti-Phospholipid antibody, lupus
anticoagulant are checked and tests are carried out for Sickle Cell syndrome.
Some probable causes and high risk factors are
-Vasculitis
-Vasculopathy
-Pre eclampsia syndrome, that means BP increases during
pregnancy
- Chronic hypertension that means the woman was already
having high BP when she became pregnant
-She may already be having arterio-venous malformation,
meaning there is structural defect in the lining of blood vessels in brain
which may lead to spontaneous rupture of some blood vessels known as arterial
dissection.
-Some clots may form in the brain. If it is in the artery it
is known as arterial thrombosis, if it is in the veins it is known as venous
thromboses.
-In Sickle Cell disease faulty haemoglobin structure causes
change in the shape of red blood cells. With altered shape these RBC get stuck
in micro vasculature. Coupled with the hypercoagulable state of pregnancy,
clotting in brain can occur and give rise to stroke.
-Cocaine and methamphetamines drug abuse also put pregnant
women at more risk
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