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Current Neurology and Neuroscience Reports
Erschienen in: Current Neurology and Neuroscience Reports 7/2016

01.07.2016 | Neurology of Systemic Diseases (J Biller, Section Editor)

Neurological Complications of Pregnancy

verfasst von: H. Steven Block

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 7/2016

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Abstract

Physiologic alterations during pregnancy create an environment for the occurrence of disease states that are either unique to pregnancy, occur more frequently in pregnancy, or require special management considerations that may be different from the nonpregnancy state. In the realm of cerebrovascular disease, preeclampsia, eclampsia, reversible cerebral vasoconstriction syndrome, sources of cardiogenic embolization including peripartum cardiomyopathy, cerebral venous thrombosis, pituitary apoplexy, subarachnoid hemorrhage, intracerebral hemorrhage, and special considerations for anticoagulation during pregnancy will be discussed. Management of epilepsy during pregnancy counterbalances maternal freedom from seizures against the potential for major, minor, cognitive, and behavioral fetal deformities. Teratogenic potential of the most common anticonvulsants are described. Considerations for anticonvulsant level monitoring during pregnancy are based upon differences in medication clearance in comparison to the prepregnancy state. The most common neuromuscular disorders of pregnancy are reviewed.
Literatur
1.
Koga K, Osuga Y, Yoshino O, et al. Elevated serum soluble vascular endothelial growth factor receptor 1 (sVEGR-1) levels in women with preeclampsia. J Clin Endocrinol Metab. 2003;88:2348–51.CrossRefPubMed
2.
Levine R, Maynard S, Quian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 350:672-683 [Erratum, N Engl Med 2006;355:1840.]
3.
Levine RJ, Lam C, Qian C, et al. Soluble endoglin and other circulating anti-angiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005.CrossRefPubMed
4.
Rana S, Karumananchi SA, Levine RJ, et al. Sequential changes in anti-angiogenic factors in early pregnancy and risk of developing preeclampsia. Hypertension. 2007;50:137–42.CrossRefPubMed
5.••
Block HS, Biller J. Neurology of pregnancy. Handbook of Clinical Neurology, volume 121 (third series), Chapter 105. Neurol Asp Syst Dis Part III. 2014;121:1595–1622. Amsterdam, Elsevier. Detailed review of the underlying mechanisms of vascular endothelial syndromes of pregnancy, antiphospholipid syndromes, and an expanded discussion of neuromuscular disorders and multiple sclerosis during pregnancy.
6.
Comeglio P, Fedi S, Liotta A, et al. Blood clotting activation during normal pregnancy. Thromb Res. 1996;84:199–202.CrossRefPubMed
7.
Cerneca F, Ricci G, Simeone R, et al. Coagulation and fibrinolysis changes in normal pregnancy. Increased levels of procoagulants and reduced levels of inhibitors during pregnancy induce a hypercoagulable state, combined with a reactive fibrinolysis. Eur J Obstet Gynecol Reprod Biol. 1997;73:31–6.CrossRefPubMed
8.
American College of Obstetrics and Gynecologists. Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122–31.CrossRef
9.
Levi M. Disseminated intravascular coagulation (DIC) in pregnancy and the peri-partum period. Thromb Res. 2009;123 Suppl 2:S63–4.CrossRefPubMed
10.
11.
Carr DB, Epplein M, Johnson CO, et al. A sister’s risk: family history as a predictor of preeclampsia. Am J Obstet Gynecol. 2005;193:965–72.CrossRefPubMed
12.••
Myatt L, Roberts JM. Preeclampsia: syndrome or disease? Curr Hypertens Rep. 2015;17:83. Excellent paper regarding preeclampsia mechanisms. CrossRefPubMed
13.
Zarate A, Saucedo R, Valencia J, et al. Early disturbed placental ischemia and hypoxia creates immune alteration and vascular disorder causing preeclampsia. Arch Med Res. 2014;45:519–24.CrossRefPubMed
14.
15.
LaMarca B, Wallace K, Granger J. role of angiotensin II type I receptor agonistic autoantibodies (AT1-AA) and preeclampsia. Curr Opin Pharmacol. 2011;11:175–9.CrossRefPubMedPubMedCentral
16.
Bushnell C, McCullough LD, Awad I, et al. Guidelines for prevention of stroke in women. Stroke. 2014;45:1545–88.CrossRefPubMed
17.
Brown DW, Dueker N, Jamieson D, et al. Preeclampsia and the risk of ischemic stroke among young women: results from the Stroke Prevention in Young Women Study. Stroke. 2006;37:1055–9.CrossRefPubMed
18.
Melchiorre K, Sutherland GR, Liberati M, et al. Preeclampsia is associated with persistent postpartum cardiovascular impairment. Hypertension. 2011;58:709–15.CrossRefPubMed
19.
Bellamy L, Casas J-P, Hingorani AD, et al. Preeclampsia and risk of cardiovascular disease and cancer in later life: systematic review and manner-analysis. BMJ. 2007;335:974.CrossRefPubMedPubMedCentral
20.
21.
Pacheco NL, Anderson AM, Kamper-Jorgensen M. Preeclampsia and breast cancer: the influence of birth characteristics. Breast. 2015;24:613–7.CrossRefPubMed
22.
Ducros A, Fiedler U. Porscher R l. Hemorrhagic manifestations of reversible cerebral vasoconstriction syndrome. Frequency, features and risk factors. Stroke. 2010;41:2505–11.CrossRefPubMed
23.
Wilson D, Marshall CR, Solbach T, et al. Intraventricular hemorrhage in reversible cerebral vasoconstriction syndrome. J Neurol. 2014;261:2221–4.CrossRefPubMedPubMedCentral
24.
Iancu-Gontard D, Oppenheim C, Touze E, et al. Evaluation of hyperintense vessels on FLAIR MRI for the diagnosis of multiple intracerebral arterial stenoses. Stroke. 2003;34:1886–91.CrossRefPubMed
25.
Komatsu T, Kimura T, Yagishita A, et al. A case of reversible cerebral vasoconstriction syndrome presenting with recurrent neurological deficits: evaluation using non-invasive arterial span labeling MRI. Clin Neurol Neurosurg. 2014;126:96–8.CrossRefPubMed
26.
Rosenbloom MH, Singhal A. CT angiography and diffusion-perfusion MR imaging in a patient with ipsilateral reversible cerebral vasoconstriction after carotid endarterectomy. Am J Neuroradiol. 2007;28:920–2.PubMed
27.
Calabrese LH, Dodick DW, Schwedt TJ, et al. Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med. 2007;146:34–44.CrossRefPubMed
28.••
Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol. 2012;11:906–17. Exceptional subject review. CrossRefPubMed
29.
Mitchell LA, Santarelli JG, Singh IP, et al. Reversible cerebral vasoconstriction syndrome and bilateral vertebral artery dissection presenting in a patient after cesarean section. J Neurol Intervent Surg. 2014;6, e5. doi:10.​1136/​neurointsurg-2012-010521.​rep.
30.
Hoeren M, Hader C, Strumpell S, et al. Peripartum angiopathy with simultaneous sinus venous thrombosis, cervical artery dissection and cerebral artery vasoconstriction. J Neurol. 2011;258:2080–2.CrossRefPubMed
31.
Nouh A, Ruland S, Schneck MJ, et al. Reversible cerebral vasoconstriction syndrome with multiple vessel cervical artery dissections and a double aortic arch. J Stroke Cerebrovasc Dis. 2014;23:e141–3.CrossRefPubMed
32.
John S, Hajj-Ali RA, Min D, et al. Reversible cerebral vasoconstriction syndrome: is it more than just cerebral vasoconstriction? Cephalgia. 2015;35:631–4.CrossRef
33.
Mukerji S, Buchbinder B, Singhal A. Reversible cerebral vasoconstriction syndrome with reversible renal artery stenosis. Neurology. 2015;85:201–2.CrossRefPubMed
34.
Shaik S, Chhetri SK, Roberts G, et al. Reversible cervical vasoconstriction syndrome with involvement of external carotid artery branches. Neurohospitalist. 2014;4:141–3.CrossRefPubMedPubMedCentral
35.
Singhal A, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndromes. Analysis of 139 cases. Arch Neurol. 2011;68:1005–12.CrossRefPubMed
36.
37.
Fugate J, Ameriso S, Ortiz G, et al. Variable presentations of postpartum angiopathy. Stroke. 2012;43:670–6.CrossRefPubMed
38.
Andra J. Pregnancy and thrombotic risk. Crit Care Med. 2010;38:S57–63.CrossRef
39.
Bouabdallaoul N, Mouquet F, Lebreton G, et al. Current knowledge and recent development on management of peripartum cardiomyopathy. Eur Heart J Acute Cardiovasc Care. doi: 10.​1177/​2048872615612465​.
40.
Reuwer A, Reuwer PJHM, van der Post, et al. Prolactin fragmentation by trophoblastic matrix metalloproteinases as a possible contributor to peripartum cardiomyopathy and pre-eclampsia. Med Hypotheses. 2010;74:348–52.CrossRefPubMed
41.
Blauwet LA, Cooper LT. Diagnosis and management of peripartum cardiomyopathy. Heart. 2011;97:1970–81.CrossRefPubMed
42.
Patel S, Obeid H, Matti, et al. Cerebral venous thrombosis. Current and newer anticoagulant treatment options. Neurologist. 2015;20:80–8.CrossRefPubMed
43.
Caprio F, Bernstein R. Duration of anticoagulation after cerebral venous sinus thrombosis. Neurocrit Care. 2012;16:335–42.CrossRefPubMed
44.
De Sousa D, Canhao P, Ferro J. Safety of pregnancy after cerebral venous thrombosis. A systematic review. Stroke. 2016;47:713–8.
45.
Hall J, Pauli R, Wilson K. Maternal and fetal sequela of anticoagulation during pregnancy. Am J Med. 1980;68:122–40.CrossRefPubMed
46.
Nishimura R et al. AHA/ACC guidelines for the management of patients with valvular heart disease. Circulation. 2014;129:e521–643. Excellent topic review.CrossRefPubMed
47.•
Bates S et al. VTE, thrombophilia, antithrombotic therapy and pregnancy. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(2):e691S–736. Excellent topic review. CrossRefPubMedPubMedCentral
48.
Regitz-Zagrosek V et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the task force on management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:3147–97.CrossRefPubMed
49.
McClintock C. Thromboembolism in pregnancy: challenges and controversies in the prevention of pregnancy-associated venous thromboembolism and management of anticoagulation in women with mechanical prosthetic heart valves. Best Pract Res Clin Obstet Gynecol. 2014;28:519–36.CrossRef
50.
McClintock C. Anticoagulant choices in pregnant women with mechanical heart valve is: balancing maternal and fetal risks-the difference the dose makes. Thromb Res. 2013;131 Suppl 1:S8–10.CrossRef
51.
Galland F, Vantyghem M-C, Cazabat L, et al. Management of nonfunctioning pituitary incidentaloma. Ann Endocrinol. 2015;76:191–200.CrossRef
52.
Castinetti F, Dufor H, Gaillard S, et al. Nonfunctioning pituitary adenoma: when and how to operate? What pathologic criteria for typing? Ann Endocrinol. 2015;76:220–7.CrossRef
53.
Liu Z-H, Tu P-H, Pai P-C, et al. Predisposing factors of pituitary hemorrhage. Eur J Neurol. 2012;19:733–8.CrossRefPubMed
54.
Shirataki K, Chihara K, Shibata Y, et al. Pituitary apoplexy manifested during a bromocriptine test in a patient with a growth hormone-and prolactin-producing pituitary adenoma. Neurosurgery. 1988;23:395–8.CrossRefPubMed
55.
56.
Semple PL, Jane JA, Laws ER. Clinical relevance of precipitating factors in pituitary apoplexy. Neurosurgery. 2007;61:956–62.CrossRefPubMed
57.
Murao K, Imachi H, Muraoka T, et al. Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with pituitary apoplexy. Fertil Steril. 2011;96:260–1.CrossRefPubMed
58.
Mathur D, Lim LFM, Mathur M, et al. Pituitary apoplexy with reversible cerebral vasoconstriction syndrome after spinal anesthesia for emergency cesarean section: an uncommon cause for postpartum headache. Anaesth Intensive Care. 2014;42:99–105.PubMed
59.
Tessnow AH, Wilson JD. The changing face of Sheehan’s Syndrome. Am J Med Sci. 2010;340:402–6.CrossRefPubMed
60.
Lin N, Zenonos G, Kim A, et al. Angiogram-negative subarachnoid hemorrhage: relationship between bleeding pattern and clinical outcome. Neurocrit Care. 2012;16:389–98.CrossRefPubMed
61.
Wong GK, Teoh J, Chan EK, Ng SC, Poon WS. Intracranial aneurysm size responsible for spontaneous subarachnoid hemorrhage. Br J Neurosurg. 2012.
62.
Nieuwkamp DJ, Setz LE, Alga A, et al. Changes in case fatality of aneurysmal subarachnoid hemorrhage over time, according to age, sex and region: a meta-analysis. Lancet Neurol. 2009;8:635–42.CrossRefPubMed
63.
Connolly E, Rabinstein A, Carhuapoma J, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. Stroke. 2012;43:1711–37.CrossRefPubMed
64.
Wang J, Wang R, Zhao J. Ruptured cerebral aneurysm from choriocarcinoma. Case Rep/J Clin Neurosci. 2013;20:1324–6.CrossRef
65.
Bateman B, Olbrecht V, Berman M, et al. Peripartum subarachnoid hemorrhage. Nationwide data and institutional experience. Anesthesiology. 2012;116:324–33.CrossRefPubMed
66.
Takahashi J, Iihara K, Ishii A, et al. Pregnancy-associated intracranial hemorrhage: results of the survey of neurological institutes across Japan. J Stroke Cerebrovasc Dis. 2014;23:e65–71.CrossRefPubMed
67.
68.
Bhakta J, Bainbridge J, Borgelt L. Teratogenic medications and concurrent contraceptive use in women of childbearing ability with epilepsy. Epilepsy Behav. 2015;52:212–7.CrossRefPubMed
69.
Harden CL, Hopp J, Ting TY, et al. Practice parameter update: management issues for women with epilepsy-focus on pregnancy (and evidence-based review): obstetrical complications and change in seizure frequency. Neurology. 2009;73:126–32.CrossRefPubMedPubMedCentral
70.
Battino D, Tomson T, Bonizzoni E, et al. Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia. 2013;54:1621–7.CrossRefPubMed
71.
Reisinger T, Newman M, Loring D, et al. Antiepileptic drug clearance in seizure frequency during pregnancy in women with epilepsy. Epilepsy Behav. 2013;29:13–8.CrossRefPubMedPubMedCentral
72.
Yerby MS. Management issues for women with epilepsy. Neural tube defects and folic acid depletion. Neurology. 2003;61 suppl 2:S23–6.CrossRefPubMed
73.
Meador K, Baker G, Browning N, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med. 2009;360:1597–605.CrossRefPubMedPubMedCentral
74.
75.
Meador K, Baker G, Browning N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol. 2013;12:244–52.CrossRefPubMedPubMedCentral
76.
Desmukh U, Adams J, Macklin E, et al. Behavior outcomes in children exposed prenatally to lamotrigine, valproate, or carbamazepine. Neurotoxicol Teratol. 2016;54:5–14.CrossRef
77.
Voinescu P, Penell P. Management of epilepsy during pregnancy. Expert Rev Neurother. 2015;15:1171–87.CrossRefPubMed
78.
Tomson T, Battino D. Teratogenic effects of antiepileptic drugs. Lancet Neurol. 2012;11:803–13.CrossRefPubMed
79.
Vajda F, O’Brien T, Graham J, et al. The outcomes of pregnancy in women with untreated epilepsy. Seizure. 2015;24:77–81.CrossRefPubMed
80.
81.
Pickrell W, Elwyn G, Smith P. Shared decision-making in epilepsy management. Epilepsy Behav. 2015;47:78–82.CrossRefPubMed
82.
Hilsinger R, Adour K, Doty H. Idiopathic facial paralysis, pregnancy and the menstrual cycle. Ann Otolaryngol Rhinol Laryngol. 1975;84:433–42.CrossRef
83.
Vogell A, Boelig R, Sorka J, et al. Bilateral Bell's palsy as a presenting sign of preeclampsia. Obstet Gynecol. 2014;124(2, part 2 suppl 1):459–61.CrossRefPubMed
84.
Gillman G, Schaitkin B, May M. Bell's palsy and pregnancy: a study of recovery outcomes. Otolaryngol Head Neck Surg. 2002;126:26–30.CrossRefPubMed
85.
Weimer LH, Yin J, Lovelace RE, et al. Serial studies of carpal tunnel syndrome during and after pregnancy. Muscle Nerve. 2002;25:914–7.CrossRefPubMed
86.
87.
Norwood F, Dhanjal M, Hill A, et al. Myasthenia in pregnancy: best practices from the UK multispecialty working group. J Neurol Neurosurg Psychiatry. 2014;85:538–54.CrossRefPubMed
Metadaten
Titel
Neurological Complications of Pregnancy
verfasst von
H. Steven Block
Publikationsdatum
01.07.2016
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 7/2016
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-016-0665-2

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