Neurological Disorders in Puerperium: A Tertiary Care Experience.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 5
Abstract
Background: Puerperium is the period of adjustment after child-birth during which the mothers reproductive system returns to its normal prepregnant state. It generally lasts six to eight weeks and end with the first ovulation and the return of normal menstruation. A variety of neurological disorders may be encountered during puerperium. The primary neurological disorders studied in relation to puerperum include stroke, epilepsy, benign intracranial hypertension, continuous demyelinating diseases of central and peripheral nervous system and peripheral neuropathy. Materials and Methods: A prospective observational study wherein the clinical profile of patients presenting with neurological disorders during puerperium was studied. Patients with pre-existing neurological disorders and eclampsia were excluded from the study. Detailed history, examination and relevant investigation like CT head, MRI brain, EEG etc. were done and statistical analysis using Microsoft Excel spreadsheet was done. Results: Out of 36550 hospital deliveries in 2 years, 74 patients had postpartum neurological complications giving an incidence 337 per lac deliveries. Majority of patients were in their 3rd and 4th decade of life. Majority of patients had PRES and almost equal percentage 15% patients had GBS and ischemic stroke and 12.2% had cerebral venous thrombosis. Majority of our patients had generalized tonic clonic seizures. Majority (44.6%) of our patients (60.8%) had undergone caesarean section while 29 (39.2%) had normal vaginal delivery. Conclusion: Posterior reversible encephalopathy syndrome PRES and ischemic stroke (PRESS) emerge as the predominant neurological disorders during puerperium with a substantial contribution by peripheral neuropathy, cerebrovascular disease and CNS infections. Appropriate management, preferably under the joint care of neurologists, obstetricians and neurosurgeons is required to optimize the maternal and foetal outcome.
Authors and Affiliations
Dr. Omar Farooq
Keywords
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