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Archivos de Medicina de Urgencia de México

2024, Number 3

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Arch Med Urg Mex 2024; 16 (3)

Neurological emergencies in pregnant patients. Experience of a highly specialized center in Mexico City

Vázquez-Rodríguez JG, Ruíz-Huitrón RM

Language: Spanish
References: 20
Page: 172
PDF size: 332.51 Kb.


ABSTRACT

Background: Neurological emergencies during pregnancy and postpartum increase the rate of maternal and fetal morbidity and mortality.
Objective: identify the clinical characteristics, neurological emergencies and perinatal outcomes in pregnant or postpartum patients admitted to the Intensive Care Unit (ICU) of a highly specialized center in Mexico City.
Material and methods: a retrospective, cross-sectional, observational study was carried out in a cohort of 51 patients admitted to the ICU in 2021 and 2022 due to neurological emergencies during pregnancy or in the postpartum stage. Charts were consulted to document clinical characteristics, neurological emergencies, and perinatal outcomes. The data were analyzed using descriptive statistical measures (mean, median, standard deviation, range) with the SPSS™ version 22 statistical program.
Results: maternal age 28.57 ± 7.17 years, gestational age 29.76 ± 6.30 weeks, 64.70% pregnant and 35.30% postpartum. Neurological emergencies were eclampsia 52.94%, epilepsy 31.37%, venous thrombosis of the longitudinal sinus 3.92%, parenchymal hemorrhage 3.92%, posterior reversible encephalopathy 3.92%, eclampsia with cerebral venous thrombosis 1.96% and cerebral edema due to active neurocystercosis 1.96%. The maternal stay in the ICU was 2.87±2.01 days, mortality 0% and organic lesions requiring highly specialized management 23.52%. Fifty newborns were obtained with prematurity 44%, serious complications requiring intensive care 100%, and fetal mortality 14%.
Conclusion: intensive and multidisciplinary management reduced the acute maternal effect of neurological emergencies, but not organic lesions. The fetal morbidity and mortality rate was very high.


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