Pakistan journal of medical sciences · 2025
Neurological disorders in Pregnancy: Radiological insights and Obstetric implications.
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Aziz Rukhsana, Yasmin Sumaira, Aman Nasreen, Shams Huma
Аннотация
OBJECTIVE: To explore the radiological findings of neurological disorders in obstetrics patients, their obstetric and fetal outcome.
METHOD: The cross-sectional study was conducted at Lady Ready Hospital (LRH), Peshawar from June 2022 till March, 2023. Sixty two obstetric patients with neurological symptoms were included. Their clinical records were explored. MRI/MRV brain were performed in patients requiring brain imaging and followed till the end of pregnancy.
RESULTS: Seizures were the commonest symptom found in 74.2% patients followed by hemiparesis; 8.1%. About 92% had never experienced hypertension and 62.3% had pregnancy-induced hypertension in current pregnancy. Twenty eight patients underwent MRI, revealing Dural sinus thrombosis (DST) in 42.9%, posterior reversible encephalopathy syndrome (PRES) in 17.9%, infarcts in 14.3% and hemorrhage in 7.1%. Normal baby was born in 69% patients; stillbirth, preterm birth and miscarriage were found in 25.9%, 3.2% and 1.6% respectively. Apgar scores of 7-10, 4-6 and 0-3 were found in 67.2%, 6.9% and 25.9% respectively. Fits were observed in 10.3% babies and 32.8% required neonatal intensive care unit (NICU) care. Fits and ischemic infarct were commoner in prenatal. DST and PRES were commoner in postnatal patients. All PRES patients presented with fits. DST patients presented with fits, headache, hemiparesis and altered consciousness. All PRES patients delivered normal alive babies. DST mothers delivered alive babies at term in 81.8%, dead pre-term baby and miscarriage in 9.1% each.
CONCLUSION: Pregnancy-related neurological problems should be taken carefully and evaluated, since even seemingly insignificant symptoms like headaches may be signs of serious illnesses like PRES or DST.
METHOD: The cross-sectional study was conducted at Lady Ready Hospital (LRH), Peshawar from June 2022 till March, 2023. Sixty two obstetric patients with neurological symptoms were included. Their clinical records were explored. MRI/MRV brain were performed in patients requiring brain imaging and followed till the end of pregnancy.
RESULTS: Seizures were the commonest symptom found in 74.2% patients followed by hemiparesis; 8.1%. About 92% had never experienced hypertension and 62.3% had pregnancy-induced hypertension in current pregnancy. Twenty eight patients underwent MRI, revealing Dural sinus thrombosis (DST) in 42.9%, posterior reversible encephalopathy syndrome (PRES) in 17.9%, infarcts in 14.3% and hemorrhage in 7.1%. Normal baby was born in 69% patients; stillbirth, preterm birth and miscarriage were found in 25.9%, 3.2% and 1.6% respectively. Apgar scores of 7-10, 4-6 and 0-3 were found in 67.2%, 6.9% and 25.9% respectively. Fits were observed in 10.3% babies and 32.8% required neonatal intensive care unit (NICU) care. Fits and ischemic infarct were commoner in prenatal. DST and PRES were commoner in postnatal patients. All PRES patients presented with fits. DST patients presented with fits, headache, hemiparesis and altered consciousness. All PRES patients delivered normal alive babies. DST mothers delivered alive babies at term in 81.8%, dead pre-term baby and miscarriage in 9.1% each.
CONCLUSION: Pregnancy-related neurological problems should be taken carefully and evaluated, since even seemingly insignificant symptoms like headaches may be signs of serious illnesses like PRES or DST.