Abstract
Introduction: A variety of neurological disorders may be encountered during pregnancy and puerperium. These disorders may be unrelated to the pregnant state (e.g., tuberculous meningitis) or peculiar to or more prevalent during pregnancy which are still a cause of significant maternal morbidity and mortality in rural India (e.g., eclampsia and cortical venous thrombosis). Aim: To study the clinical profile of patients presenting with primary and secondary neurological disorders during pregnancy and puerperium and their outcome. Materials and Methods: This study was carried out at the Mamata Medical College between january 2009 and december 2013. All antenatal patients, postabortal or postpartum period requiring neurological consultation were included in this study. Women with eclampsia were excluded. Results: There were 75 women included in this study, with 45 cases of primary and 30 of secondary neurological disorders. The former included epilepsy,21 CNS infections,12 cerebrovascular disorders,9 intra cranial tumour,1 post traumatic paresis1 and encephalomyelitis.1 The latter included hepatic encephalopathy,28 enteric encephalopathy1 and polyneuropathy.1 In patients of epilepsy, the seizures had an equal distribution in all the trimesters and post-partum period, they were mainly of generalized type (77.27%) and were controlled in the majority (90.9%). No fetal congenital malformations were seen. Tubercular meningitis,8 pyogenic meningitis3 and viral encephalitis1 were the CNS infections encountered and pregnancy outcome was good in most cases. All cases of CVT presented in the postpartum period with fever and neurological signs following delivery. Among them 2 patients recovered completely, one patient had residual deficits, another had persistent seizures. We had one maternal death. HE affected patients mainly during the latter half of pregnancy or the post-partum period and was associated with 64.3% mortality. Conclusion: The incidence of neurological dis
Highlights
A variety of neurological disorders may be encountered during pregnancy and puerperium
These disorders may be unrelated to the pregnant state or peculiar to or more prevalent during pregnancy which are still a cause of significant maternal morbidity and mortality in rural India
Out of the 75 patients presented during pregnancy or puerperium with neurological disorders during the study period, 45 cases were of primary neurological disorders and 30 cases were of secondary neurological disorders
Summary
A variety of neurological disorders may be encountered during pregnancy and puerperium These disorders may be unrelated to the pregnant state (e.g., tuberculous meningitis) or peculiar to or more prevalent during pregnancy which are still a cause of significant maternal morbidity and mortality in rural India (e.g., eclampsia and cortical venous thrombosis). These disorders may be unrelated to the pregnant state (e.g., tuberculous meningitis) or peculiar to or more prevalent during pregnancy which are still a cause of significant maternal morbidity and mortality in rural India. Neurological disorders may influence the management of otherwise uncomplicated obstetric cases necessitating a multi disciplinary team work involving physician and neurologist
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