Citation Information :
Giliyar S. Neurological Disorders Complicating Pregnancy and its Obstetric Outcomes. Int J Infertil Fetal Med 2023; 14 (2):59-64.
Objective: To find the common neurological disorders complicating pregnancy and their obstetric outcome.
Materials and methods: This was a retrospective study conducted over a period of 3 years and included all pregnant women with a diagnosis of neurologic disorders who were admitted to the Obstetrics and Gynecology Department at St John's Medical College, St John's National Academy of Health Sciences (SJNAHS), Bengaluru, Karnataka, India. The study was carried out from January 2016 to December 2018.
Results: A total of 60 patients with neurologic disorders were identified during the study period of 3 years. In our study, 57 (95%) women were in the 20–35-year age-group, and the majority were primigravida 38 (63.3%). A total of 56 women (93.3%) delivered at term. A total of 28 (46.6%) women had a cesarean section, and 27 (45%) had a vaginal delivery. Among the neurologic disorders in pregnancy, 36 (60%) women had epilepsy, seven (11.6%) cerebrovascular diseases, six (10%) polio survivors, and four (6.6%) central nervous system (CNS) infections. A total of 16 (44.4%) women with epilepsy (WWE) were seizure-free in index pregnancy, 15 (41.6%) had relapse of seizures during present pregnancy, and five (13.8%) had been newly diagnosed with epilepsy in the index pregnancy. There were no maternal or perinatal deaths.
Conclusion: Multidisciplinary approach in a tertiary care center improves both maternal and fetal outcomes.
Paily VP, Ambujam K, Rajasekharan Nair V, et al. Confidential review of maternal deaths in Kerala: a country case study. BJOG 2014;121(s4):61–66. DOI: 10.1111/1471-0528.13000
MBRRACE-UK Maternal Report 2019 - WEB VERSION.pdf [Internet]. [cited 2020 Oct 30]. Available from: https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202019%20-%20WEB%20VERSION.pdf
Gupta S, Rohatgi A, Sharma SK, et al. A study of neurological disorders during pregnancy and puerperium. Ann Indian Acad Neurol 2006;9(3):152–157. DOI: 10.4103/0972-2327.27657
Sarella LK, Rao DS. Neurological disorders in pregnancy and puerperium. Sri Lanka J Obstet Gynaecol 2014;36(3):74–78. DOI: 10.4038/sljog.v36i3.7722
Renukesh S, Rai L. Neurological disorders complicating pregnancy - focus on obstetric outcome. J Clin Diagn Res 2016;10(12):QC06– QC09. DOI: 10.7860/JCDR/2016/19839.8955
Thomas SV, Syam U, Devi JS. Predictors of seizures during pregnancy in women with epilepsy. Epilepsia 2012;53(5):e85–e88. DOI: 10.1111/j.1528-1167.2012.03439.x
Li W, Hao N, Xiao Y, et al. Clinical characteristics and pregnancy outcomes of new onset epilepsy during pregnancy. Medicine (Baltimore) 2019;98(27):e16156. DOI: 10.1097/MD.0000000000016156
Harden CL, Hopp J, Ting TY, et al. Practice parameter update: management issues for women with epilepsy–focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):126–132. DOI: 10.1212/WNL.0b013e3181a6b2f8
Bansal R, Suri V, Chopra S, et al. Levetiracetam use during pregnancy in women with epilepsy: preliminary observations from a tertiary care center in Northern India. Indian J Pharmacol 2018;50(1):39–43. DOI: 10.4103/ijp.IJP_692_17
Koubeissi M. Levetiracetam: more evidence of safety in pregnancy. Epilepsy Curr 2013;13(6):279–281. DOI: 10.5698/1535-7597-13.6.279
Viale L, Allotey J, Cheong-See F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015;386(10006):1845–1852. DOI: 10.1016/S0140-6736(15)00045-8
Sharma N, Sharma SR, Hussain M. An audit of cerebral venous thrombosis associated with pregnancy and puerperium in teaching hospital in North Eastern India. J Family Med Prim Care 2019;8(3):1054–1057. DOI: 10.4103/jfmpc.jfmpc_366_18
Lv X, Liu P, Li Y. Preexisting, incidental and hemorrhagic AVMs in pregnancy and postpartum: gestational age, morbidity and mortality, management and risk to the fetus. Interv Neuroradiol 2016;22(2):206–211. DOI: 10.1177/1591019915622161
Lv X, Li Y. The clinical characteristics and treatment of cerebral AVM in pregnancy. Neuroradiol J 2015;28(4):385–388. DOI: 10.1177/1971400915609332
Bateman BT, Olbrecht VA, Berman MF, et al. Peripartum subarachnoid hemorrhage: nationwide data and institutional experience. Anesthesiology 2012;116(2):324–333. DOI: 10.1097/ALN.0b013e3182410b22
Roman H, Descargues G, Lopes M, et al. Subarachnoid hemorrhage due to cerebral aneurysmal rupture during pregnancy. Acta Obstet Gynecol Scand 2004;83(4):330–334. DOI: 10.1111/j.0001-6349.2004.00281.x
Akers A, Al-Shahi Salman R, A Awad I, et al. Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel. Neurosurgery 2017;80(5):665–680. DOI: 10.1093/neuros/nyx091
Veiby G, Daltveit AK, Gilhus NE. Pregnancy, delivery and perinatal outcome in female survivors of polio. J Neurol Sci 2007;258(1–2):27–32. DOI: 10.1016/j.jns.2007.02.019
Sugarman J, Colvin C, Moran AC, et al. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health 2014;2(12):e710–e716. DOI: 10.1016/S2214-109X(14)70330-4
Yadav V, Sharma JB, Kachhawa G, et al. Obstetrical and perinatal outcome in pregnant women with extrapulmonary tuberculosis. Indian J Tuberc 2019;66(1):158–162. DOI: 10.1016/j.ijtb.2018.10.010
Bartt R. Acute bacterial and viral meningitis. Continuum (Minneap Minn) 2012;18(6):1255–1270. DOI: 10.1212/01.CON.0000423846.40147.4f
Logan SA, MacMahon E. Viral meningitis. BMJ 2008;336(7634):36–40. DOI: 10.1136/bmj.39409.673657.AE
Adriani KS, Brouwer MC, van der Ende A, et al. Bacterial meningitis in pregnancy: report of six cases and review of the literature. Clin Microbiol Infect 2012;18(4):345–351. DOI: 10.1111/j.1469-0691.2011.03465.x
Kim KS. Human meningitis-associated Escherichia coli. EcoSal Plus 2016;7(1):10.1128/ecosalplus. DOI: 10.1128/ecosalplus.ESP-0015-2015
Berkmann S, Fandino J. Pregnancy and childbirth after microsurgery for lumbar disk herniation. Acta Neurochir (Wien) 2012;154(2):329–334. DOI: 10.1007/s00701-011-1207-y
Sterling L, Keunen J, Wigdor E, et al. Pregnancy Outcomes in women with spinal cord lesions. J Obstet Gynaecol Can 2013;35(1):39–43. DOI: 10.1016/s1701-2163(15)31046-x
Bushnell CD, Jamison M, James AH. Migraines during pregnancy linked to stroke and vascular diseases: US population based case-control study. BMJ 2009;338:b664. DOI: 10.1136/bmj.b664
Negro A, Delaruelle Z, Ivanova TA, et al. Headache and pregnancy: a systematic review. J Headache Pain 2017;18(1):106. DOI: 10.1186/s10194-017-0816-0
Terry AR, Barker FG 2nd, Leffert L, et al. Neurofibromatosis type 1 and pregnancy complications: a population-based study. Am J Obstet Gynecol 2013;209(1):46.e1–46.e8. DOI: 10.1016/j.ajog.2013.03.029
Almalki MH, Alzahrani S, Alshahrani F, et al. Managing prolactinomas during pregnancy. Front Endocrinol 2015;6:85. DOI: 10.3389/fendo.2015.00085