title: Management of eclampsia and stroke during pregnancy.
abstract: To establish the etiologies and therapeutic strategies for the treatment of eclampsia and stroke during pregnancy, we performed a questionnaire-based study of stroke during pregnancy in Aichi prefecture (2005-2009). This study revealed the following findings: 66% of deliveries were managed in primary medical institutions, 40% of eclampsia episodes and 31% of strokes occurred at primary medical institutions, and 19% of strokes occurred at home. Home-onset strokes displayed a mortality rate of 40%. Using the results of this questionnaire, we investigated cases of eclampsia and/or stroke during pregnancy and revealed important issues regarding their management. In pregnant women with eclampsia or stroke, accurate antihypertensive and anticonvulsive treatment are necessary. Discriminating between eclampsia and stroke during labor is difficult. However, when facial or arm muscle weakness or a facial deficit is detected, stroke should be strongly suspected. Brain computed tomography can usually detect most cases of hemorrhagic stroke. When a stroke is detected, collaborative treatment with a neurosurgeon should be started as soon as possible. If stroke is suspected at a primary medical institution, rapid maternal transport to an intensive medical institution is necessary. In patients whose blood pressure is greater than 180/120 mmHg, the use of MgSO4 to decrease the risk of convulsions and reduce blood pressure is recommended. These findings might aid the development of therapeutic strategies for pregnant women with eclampsia or stroke.
authors: Ohno Ladies Clinic, Iwakura, Aichi, Japan. yasumasa@ohno-clinic.jp
authors: Yasumasa
authors: Y
authors: Ohno
authors: Michiyasu
authors: M
authors: Kawai
authors: Shigehiko
authors: S
authors: Morikawa
authors: Katsumi
authors: K
authors: Sakakibara
authors: Kanji
authors: K
authors: Tanaka
authors: Kaoru
authors: K
authors: Ishikawa
authors: Fumitaka
authors: F
authors: Kikkawa
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003299:Cooperative Behavior; D003937:Diagnosis, Differential; D004461:Eclampsia / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D017809:Fatal Outcome; D005260:Female; D006700:Home Childbirth; D006769:Hospitals, General; D006801:Humans; D033183:Interdisciplinary Communication; D007564:Japan; D008278:Magnesium Sulfate / Q000627:therapeutic use; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012017:Referral and Consultation; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate