Abstract

During pregnancy and delivery, the risk of cerebrovascular disorders increases due to several physiological changes. The elevated level of estrogen stimulates the production of clotting factors, which deteriorates the risk of thromboembolism. Increased plasma volume and total blood volume lead to the risk of hypertension, and the high level of progesterone in the third trimester of pregnancy promotes the permeability of small blood vessels. The risk of developing cerebrovascular complications remains high in the postpartum period. The article describes two clinical cases of postpartum ischemic stroke as a complication after surgical delivery in young women with an aggravated somatic medical history. The treatment and follow-up of these patients during their stay in the intensive care unit included changes in management tactics, use of antiplatelet, anticoagulant, and metabolic therapy, and subsequent rehabilitation. This article describes the case-management interventions and changes in neurological symptoms of these patients, also it discusses the most likely etiological factors of cerebrovascular disorders in these cases

Highlights

  • During pregnancy and delivery, the risk of cerebrovascular disorders increases due to several physiological changes

  • MgSO4 25% – 4 мл/ч внутривенно в течение всего интраоперационного и послеоперационного периода)

  • Гипертензивные расстройства беременных (умеренная преэклампсия), наличие процессов нарушения обмена веществ (ожирение) и нарушения системы гемостаза явились общими клиническими особенностями в предоперационном периоде

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Summary

Introduction

The risk of cerebrovascular disorders increases due to several physiological changes. Так и геморрагического инсульта во время беременности составляет около 30 случаев на 100 000 родов [4]. Риск венозных тромбоэмболических осложнений оценен в 6 баллов, что соответствовало высокому риску, в связи с чем в послеоперационном периоде назначен низкомолекулярный гепарин в профилактической дозе (эноксапарин натрия 0,4 мл) в течение 6 нед.

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