Hemorrhagic strokes during pregnancy in central Indian population of Bhilai city: an observational study

Abstract

Background:Hemorrhagic strokes are medical emergencies seen in less than 50% of the strokes encountered in pregnant females, and affect 6 pregnant females from 1000000 pregnancies. Despite of a very low occurrence rate of stroke in pregnant females, it acts as major risk factors for maternal and fetal mortality and morbidity owing to alteration of mechanisms involving hemodynamic, coagulation, and cardiovascular system.Aims: The present clinical trial is a description of a single pregnant female with a stroke observed for two years. The present study also retrospectively analyzed a cohort of pregnant females to assess risks of stroke during pregnancy.Material and Methods: A 28 years female after delivery presented left temporal intraparenchymal hematoma with sub falcine herniation managed uneventfully withdecompressive craniectomy with hematoma evacuation. Additionally, the study retrospectively analyzed 1876 females data for preexisting hypertension, pregnancy-induced hypertension, eclampsia,coagulopathy, and/orthrombocytopenia. The collected data were critically analyzed and the results were formulated. Results: A total of 19 cases among 1876 had hematoma where 14(73.68%) were managed conservatively and 5(26.31%) were managed surgically, where only one subject died showing a mortality rate of 5.26%. It was seen that preexisting hypertension was there in 10.52% of subjects (n=2),whereas, pregnancy-induced hypertension was seen in 47.36% (n=9) subjects. Eclampsia was observed in 57.89% of subjects (n=11). Coagulopathy was found in 42.10% (n=8) and 36.84% (n=7) subjects respectively.Conclusion:Within its limitations, the present study shows that hemorrhagic stroke encountered during pregnancy is an emergency requiring prompt diagnosis and adequate management as it involves both maternal and fetal life.