Spectrum of Neurological Illnesses in Pregnancy - An Observational Study from a Tertiary Care Centre of Eastern India.

INTRODUCTION

Neurological disorders in pregnancy may be observed in patients with a pre-existing neurological disorder; patients developing a primary neurological disorder during the course of pregnancy or puerperium; and in patients with primary medical disorders presenting with neurological manifestations.

OBJECTIVES

The objectives of the study were to find out the magnitude of neurological disorders in pregnancy in a tertiary care hospital along with assessment of proportion of women with particular disorders among total number of neurological disorders during the course of pregnancy or puerperium (6 weeks after child birth) and also to elicit the effect of neurological disorders on pregnancy outcome, if any.

METHODS

A prospective observational longitudinal study was carried out in a tertiary care centre of Eastern India from July 2018 to June 2020 including all pregnant women attending the department of Obstetrics and Gynaecology. We screened 886 pregnant women, out of which 91 cases were identified and investigated. For the purpose of comparison of fetal and maternal outcome, 91 control subjects were chosen from the screened patients in a randomized fashion, so that the baseline characteristics of the two groups were comparable

Results

In our study, 10.3% population had neurological disorders, among which 30.8% had primary headache, 3.2% had secondary headache, 8.5% had neurological low back pain, 19.1% had epilepsy, 6.4% had cerebrovascular disorders, 27.6% had peripheral neuropathy, 4.2% had other disorders such as neuropsychiatric Wilson's disease, myasthenia gravis and compressive myelopathy. Moreover, 10.2% of the total study population was hypertensive and 2.9% were diabetic.

CONCLUSION

10.3% mothers did have some neurological disorder, the commonest of which was migraine (primary headache) followed by carpal tunnel syndrome (peripheral neuropathy) and neurological low back pain. Overall fetomaternal outcomes were favorable barring cerebro-vascular disorder and Posterior reversible encephalopathy syndrome (PRES). We recommend screening for neurological disorder from early pregnancy for early detection and appropriate management of that condition.