Clinical analysis of 19 patients with perinatal stroke

Abstract

Objective To investigate the related factors of diagnosis, treatment and prognosis of perinatal stroke patients. Methods A retrospective study was conducted in the clinical data of 19 pregnant patients with perinatal stroke in The First Affiliated Hospital of Jinan University from February 2011 to March 2016. We analyzed the relevant factors on the pathogenesis, clinical diagnosis, treatment path, prognosis of mother and fetus. Results (1) During 5 years, 36 370 pregnancies were admitted, and there were 19 patients with perinatal stroke. The incidence of perinatal stroke was 52.2/100 000. Fourteen were hemorrhagic stroke, 5 were ischemic stroke. (2) Fourteen hemorrhagic stroke patients were mainly occurred in late pregnancy. Most of their first symptoms were headache (13 cases) and nausea and vomiting (10 cases). Ten cases were unconscious on admission. Maternal prognoses were mainly relevant to the amount of bleeding, hemorrhage location, treatment method, and state of consciousness on admission and the time from symptom onset to visit. The patient with cerebral bleeding less than 15 ml recovered well after conservative treatment. Five cases with onset-to-visit interval time less than 6 hours, 4 of them had no sequelae after treatment. However, 9 cases whose onset-to-visit interval time more than 6 hours, 1 patient died, 1 patient developed into persistent vegetative state, and 5 patients had sequela. The prognoses of fetuses were relevant to the gestational age of onset, the family desire and the time interval from diagnosis to fetal treatment. (3) Five ischemic stroke patients were all cerebral veins thrombosis, mainly occurred in the first trimester of pregnancy and puerperium. Limb movement disorder was the first symptom. Maternal prognoses were mainly relevant to treatment and infarction area. The prognoses of their fetus were relevant to the onset gestational age and the family desire. Conclusions Headache, nausea and vomiting were the main clinical manifestation of hemorrhagic stroke in pregnancy, and physical movement disorder was the main clinical manifestation of ischemic stroke in pregnancy. Hemorrhagic stroke patients with onset-to-visit interval time less than 6 hours had better pregnancy outcomes. Key words: Stroke; Pregnancy, high-risk; Pregnancy outcome