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Neurocritical Care During Pregnancy and Puerperium

  • Chapter
Critical Care Neurology and Neurosurgery

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

The obstetric practice occasionally mandates for admission of unstable patients to an critical care unit. The reasons that such a patient becomes critical can be linked either directly to the physiologic changes that occur during pregnancy and the puerperium or can be independent and coincident. Because of its complexity and importance for the functional outcome of the mother, the nervous system, if affected, requires specialized management that in the past had been offered by the consulting neurology or neurosurgery service. In many cases, a team that includes neuro-intensivists and obstetricians in the neurosciences critical care unit (NSU) may better deliver the specialized care. This new concept, although an attractive idea, is not supported yet by outcome data. This chapter encompasses all these clinical situations for which, as we suggest, NSU admission may be a reasonable alternative to the obstetrical or general critical care units.

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References

  1. Mushambi MC, Halligan AW, Williamson K. Recent developments in the pathophysiology and management of pre-eclampsia. Br. J. Anaesth. 1996; 76: 133–148.

    Article  PubMed  CAS  Google Scholar 

  2. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ 1994; 309: 1395–1400.

    Article  PubMed  CAS  Google Scholar 

  3. Mabie WC, Sibai BM. Treatment in an obstetric intensive care unit. Am. J. Obstet. Gynecol. 1990; 162: 1–4.

    PubMed  CAS  Google Scholar 

  4. Ramin KD. The prevention and management of eclampsia. Obstet. Gynecol. Clin. North Am. 1999;26:489–503, ix.

    Google Scholar 

  5. Kaplan PW. Neurologic issues in eclampsia. Rev. Neurol. (Paris) 1999; 155: 335–341.

    CAS  Google Scholar 

  6. Brown CE, Cunningham FG, Pritchard JA. Convulsions in hypertensive, proteinuric primiparas more than 24 hours after delivery. Eclampsia or some other cause? J. Reprod. Med. 1987; 32: 499–503.

    PubMed  CAS  Google Scholar 

  7. Miles JF Jr, Martin JN Jr, Blake PG, Perry KG Jr, Martin RW, Meeks GR. Postpartum eclampsia: A recurring perinatal dilemma. Obstet. Gynecol. 1990; 76: 328–331.

    PubMed  Google Scholar 

  8. Porapakkham S. An epidemiologic study of eclampsia. Obstet. Gynecol. 1979; 54: 26–30.

    Article  PubMed  CAS  Google Scholar 

  9. Sibai BM. Eclampsia. VI. Maternal-perinatal outcome in 254 consecutive cases. Am. J. Obstet. Gynecol. 1990;163:1049–1054; discussion 1054–1055.

    Google Scholar 

  10. Thomas SV. Neurological aspects of eclampsia. J. Neurol. Sci. 1998; 155: 37–43.

    Article  PubMed  CAS  Google Scholar 

  11. Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N. Engl. J. Med. 1996; 334: 494–500.

    Article  PubMed  CAS  Google Scholar 

  12. Belfort MA, Moise KJ Jr. Effect of magnesium sulfate on maternal brain blood flow in preeclampsia: A randomized, placebo-controlled study. Am. J. Obstet. Gynecol. 1992; 167: 661–666.

    PubMed  CAS  Google Scholar 

  13. Borges LF, Gucer G. Effect of magnesium on epileptic foci. Epilepsia 1978; 19: 81–91.

    Article  PubMed  CAS  Google Scholar 

  14. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455–1463.

    Google Scholar 

  15. Lucas MJ, Leveno KJ, Cunningham FG. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. N. Engl. J. Med. 1995; 333: 201–205.

    Article  PubMed  CAS  Google Scholar 

  16. Walker JJ. Pre-eclampsia. Lancet 2000; 356: 1260–1265.

    Article  PubMed  CAS  Google Scholar 

  17. Lapinsky SE, Kruczynski K, Slutsky AS. Critical care in the pregnant patient. Am. J. Respir. Crit. Care Med. 1995; 152: 427–55.

    PubMed  CAS  Google Scholar 

  18. Repke JT, Robinson JN. The prevention and management of pre-eclampsia and eclampsia. Int. J. Gynaecol. Obstet. 1998; 62: 1–9.

    Article  PubMed  CAS  Google Scholar 

  19. Steyn DW, Odendaal HJ. Randomised controlled trial of ketanserin and aspirin in prevention of pre-eclampsia. Lancet 1997; 350: 1267–1271.

    Article  PubMed  CAS  Google Scholar 

  20. Bolte AC, van Eyck J, Kanhai HH, Bruinse HW, van Geijn HP, Dekker GA. Ketanserin versus dihydralazine in the management of severe early-onset preeclampsia: Maternal outcome. Am. J. Obstet. Gynecol. 1999; 180: 371–377.

    Article  PubMed  CAS  Google Scholar 

  21. Sibai BM, Mabie BC, Harvey CJ, Gonzalez AR. Pulmonary edema in severe preeclampsia-eclampsia: Analysis of thirty-seven consecutive cases. Am. J. Obstet. Gynecol. 1987; 156: 1174–1179.

    PubMed  CAS  Google Scholar 

  22. Cotton DB, Gonik B, Dorman K, Harrist R. Cardiovascular alterations in severe pregnancy-induced hypertension: Relationship of central venous pressure to pulmonary capillary wedge pressure. Am. J. Obstet. Gynecol. 1985; 151: 762–764.

    PubMed  CAS  Google Scholar 

  23. Mabie WC, Ratts TE, Sibai BM. The central hemodynamics of severe preeclampsia. Am. J. Obstet. Gynecol. 1989; 161: 1443–1448.

    PubMed  CAS  Google Scholar 

  24. Benedetti TJ, Kates R, Williams V. Hemodynamic observations in severe preeclampsia complicated by pulmonary edema. Am. J. Obstet. Gynecol. 1985; 152: 330–334.

    PubMed  CAS  Google Scholar 

  25. Rackow EC, Fein IA, Leppo J. Colloid osmotic pressure as a prognostic indicator of pulmonary edema and mortality in the critically ill. Chest 1977; 72: 709–713.

    Article  PubMed  CAS  Google Scholar 

  26. Kirshon B, Moise KJ Jr, Cotton DB, et al. Role of volume expansion in severe pre-eclampsia. Surg. Gynecol. Obstet. 1988; 167: 367–371.

    PubMed  CAS  Google Scholar 

  27. Clark SL, Cotton DB. Clinical indications for pulmonary artery catheterization in the patient with severe preeclampsia. Am. J. Obstet. Gynecol. 1988; 158: 453–458.

    PubMed  CAS  Google Scholar 

  28. Brophy E, Brophy MH. Pyridoxal phosphate normalization of the EEG in eclampsia. Electroencephalogr. Clin. Neurophysiol. 1991; 79: 36.

    Article  Google Scholar 

  29. Donaldson JO. Neurologic emergencies in pregnancy. Obstet. Gynecol. Clin. North Am. 1991; 18: 199–212.

    PubMed  CAS  Google Scholar 

  30. Magee LA, Ornstein MP, von Dadelszen P. Fortnightly review: Management of hypertension in pregnancy. BMJ 1999; 318: 1332–1336.

    Article  PubMed  CAS  Google Scholar 

  31. Egerman RS, Sibai BM. HELLP syndrome. Clin. Obstet. Gynecol. 1999; 42: 381–89.

    Article  PubMed  CAS  Google Scholar 

  32. Sullivan CA, Magann EF, Perry KG Jr, Roberts WE, Blake PG, Martin JN Jr. The recurrence risk of the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) in subsequent gestations. Am. J. Obstet. Gynecol. 1994; 171: 940–943.

    PubMed  CAS  Google Scholar 

  33. Helou J, Nakhle S, Shoenfeld S, Nasseir T, Shalev E. Postpartum thrombotic thrombocytopenic purpura: Report of a case and review of the literature. Obstet. Gynecol. Surv. 1994; 49: 785–789.

    Article  PubMed  CAS  Google Scholar 

  34. Weiner CP. Thrombotic microangiopathy in pregnancy and the postpartum period. Semin. Hematol. 1987; 24: 119–129.

    PubMed  CAS  Google Scholar 

  35. Martin JN, Jr., Files JC, Blake PG, et al. Plasma exchange for preeclampsia. I. Postpartum use for persistently severe preeclampsia-eclampsia with HELLP syndrome. Am. J. Obstet. Gynecol. 1990; 162: 126–137.

    PubMed  Google Scholar 

  36. Martin JN Jr, Perry KG Jr, Roberts WE, et al. Plasma exchange for preeclampsia: III. Immediate peripartal utilization for selected patients with HELLP syndrome. J. Clin. Apheresis 1994; 9: 162–165.

    Article  PubMed  Google Scholar 

  37. Magann EF, Bass D, Chauhan SP, Sullivan DL, Martin RW, Martin JN Jr. Antepartum corticosteroids: disease stabilization in patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP). Am. J. Obstet. Gynecol. 1994; 171: 1148–1153.

    PubMed  CAS  Google Scholar 

  38. Magann EF, Perry KG Jr, Meydrech EF, Harris RL, Chauhan SP, Martin JN Jr. Postpartum corticosteroids: Accelerated recovery from the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP). Am. J. Obstet. Gynecol. 1994; 171: 1154–1158.

    PubMed  CAS  Google Scholar 

  39. Plauche WC. Myasthenia gravis in mothers and their newborns. Clin. Obstet. Gynecol. 1991; 34: 82–99.

    Article  PubMed  CAS  Google Scholar 

  40. Plauche WC. Myasthenia gravis. Clin. Obstet. Gynecol. 1983; 26: 592–604.

    Article  PubMed  CAS  Google Scholar 

  41. Batocchi AP, Majolini L, Evoli A, Lino MM, Minisci C, Tonali P. Course and treatment of myasthenia gravis during pregnancy. Neurology 1999; 52: 447–452.

    Article  PubMed  CAS  Google Scholar 

  42. Riemersma S, Vincent A, Beeson D, et al. Association of arthrogryposis multiplex congenita with maternal antibodies inhibiting fetal acetylcholine receptor function. J. Clin. Invest. 1996; 98: 2358–2363.

    Article  PubMed  CAS  Google Scholar 

  43. Daskalakis GJ, Papageorgiou IS, Petrogiannis ND, Antsaklis AJ, Michalas SK. Myasthenia gravis and pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2000; 89: 201–204.

    Article  PubMed  CAS  Google Scholar 

  44. Fraser FC, Sajoo A. Teratogenic potential of corticosteroids in humans. Teratology 1995; 51: 45–46.

    Article  PubMed  CAS  Google Scholar 

  45. Pickrell MD, Sawers R, Michael J. Pregnancy after renal transplantation: severe intrauterine growth retardation during treatment with cyclosporin A. BMJ 1988; 296: 825.

    Article  PubMed  CAS  Google Scholar 

  46. Buckley LM, Bullaboy CA, Leichtman L, Marquez M. Multiple congenital anomalies associated with weekly low-dose methotrexate treatment of the mother. Arthritis Rheum. 1997; 40: 971–973.

    Article  PubMed  CAS  Google Scholar 

  47. Ip MS, So SY, Lam WK, Tang LC, Mok CK. Thymectomy in myasthenia gravis during pregnancy. Postgrad. Med. J. 1986; 62: 473–474.

    Article  PubMed  CAS  Google Scholar 

  48. Bril V, Kojic J, Ilse WK, Cooper JD. Long-term clinical outcome after transcervical thymectomy for myasthenia gravis. Ann. Thorac. Surg. 1998; 65: 1520–1522.

    Article  PubMed  CAS  Google Scholar 

  49. Eden RD, Gall SA. Myasthenia gravis and pregnancy: a reappraisal of thymectomy. Obstet. Gynecol. 1983; 62: 328–333.

    Article  PubMed  CAS  Google Scholar 

  50. Qureshi AI, Choudhry MA, Akbar MS, et al. Plasma exchange versus intravenous immunoglobulin treatment in myasthenic crisis. Neurology 1999; 52: 629–632.

    Article  PubMed  CAS  Google Scholar 

  51. Achiron A, Barak Y, Miron S, Sarova-Pinhas I. Immunoglobulin treatment in refractory myasthenia gravis. Muscle Nerve 2000; 23: 551–555.

    Article  PubMed  CAS  Google Scholar 

  52. Carr SR, Gilchrist JM, Abuelo DN, Clark D. Treatment of antenatal myasthenia gravis. Obstet. Gynecol. 1991; 78: 485–489.

    PubMed  CAS  Google Scholar 

  53. Chaudhry V, Cornblath DR, Griffin JW, O’Brien R, Drachman DB. Mycophenolate mofetil: A safe and promising immunosuppressant in neuromuscular diseases. Neurology 2001; 56: 94–96.

    Article  PubMed  CAS  Google Scholar 

  54. Pergola PE, Kancharla A, Riley DJ. Kidney transplantation during the first trimester of pregnancy: Immunosuppression with mycophenolate mofetil, tacrolimus, and prednisone. Transplantation 2001; 71: 994–997.

    Article  PubMed  CAS  Google Scholar 

  55. Thomas CE, Mayer SA, Gungor Y, et al. Myasthenic crisis: Clinical features, mortality, complications, and risk factors for prolonged intubation. Neurology 1997; 48: 1253–1260.

    Article  PubMed  CAS  Google Scholar 

  56. Benshushan A, Rojansky N, Weinstein D. Myasthenia gravis and preeclampsia. Isr. J. Med. Sci. 1994; 30: 229–233.

    PubMed  CAS  Google Scholar 

  57. Ho T, Griffin J. Guillain-Barre syndrome. Curr. Opin. Neurol. 1999; 12: 389–394.

    Article  PubMed  CAS  Google Scholar 

  58. Ropper AH. The Guillain-Barre syndrome. N. Engl. J. Med. 1992; 326: 1130–1136.

    Article  PubMed  CAS  Google Scholar 

  59. Jiang GX, de Pedro-Cuesta J, Strigard K, Olsson T, Link H. Pregnancy and Guillain-Barre syndrome: A nationwide register cohort study. Neuroepidemiology 1996; 15: 192–200.

    Article  PubMed  CAS  Google Scholar 

  60. Mack T, Weiner L, Gilmore W. Guillain-Barre syndrome, pregnancy, and the puerperium. Epidemiology 1998; 9: 588–590.

    Article  PubMed  CAS  Google Scholar 

  61. Luijckx GJ, Vles J, de Baets M, Buchwald B, Troost J. Guillain-Barre syndrome in mother and newborn child. Lancet 1997; 349: 27.

    Article  PubMed  CAS  Google Scholar 

  62. Nelson LH, McLean WT Jr. Management of Landry-Guillain-Barre syndrome in pregnancy. Obstet. Gynecol. 1985; 65: 25S–29S.

    PubMed  CAS  Google Scholar 

  63. van der Meche FG, Schmitz PI. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barre syndrome. Dutch Guillain-Barre Study Group. N. Engl. J. Med. 1992; 326: 1123–1129.

    Article  PubMed  CAS  Google Scholar 

  64. Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barre syndrome. Plasma Exchange/Sandoglobulin Guillain-Barre Syndrome Trial Group. Lancet 1997; 349: 225–230.

    Article  Google Scholar 

  65. Yamada H, Noro N, Kato EH, Ebina Y, Cho K, Fujimoto S. Massive intravenous immunoglobulin treatment in pregnancy complicated by Guillain-Barre syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol. 2001; 97: 101–104.

    Article  PubMed  CAS  Google Scholar 

  66. Gautier PE, Hantson P, Vekemans MC, et al. Intensive care management of Guillain-Barre syndrome during pregnancy. Intens. Care Med. 1990; 16: 460–462.

    Article  CAS  Google Scholar 

  67. Yaginuma Y, Kawamura M, Ishikawa M. Landry-Guillain-Barre-Strohl syndrome in pregnancy. J. Obstet. Gynaecol. Res. 1996; 22: 47–49.

    PubMed  CAS  Google Scholar 

  68. Brooks H, Christian AS, May AE. Pregnancy, anaesthesia and Guillain Barre syndrome. Anaesthesia 2000; 55: 894–898.

    Article  PubMed  CAS  Google Scholar 

  69. Barbour LA. Current concepts of anticoagulant therapy in pregnancy. Obstet. Gynecol. Clin. North Am. 1997; 24: 499–521.

    Article  PubMed  CAS  Google Scholar 

  70. Weiner CP. Diagnosis and management of thromboembolic disease during pregnancy. Clin. Obstet. Gynecol. 1985; 28: 107–118.

    Article  PubMed  CAS  Google Scholar 

  71. Demers C, Ginsberg JS. Deep venous thrombosis and pulmonary embolism in pregnancy. Clin. Chest. Med. 1992; 13: 645–656.

    PubMed  CAS  Google Scholar 

  72. Ferner R, Barnett M, Hughes RA. Management of Guillain-Barre syndrome. Br. J. Hosp. Med. 1987; 38: 525–528, 530.

    Google Scholar 

  73. Ropper AH. Critical care of Guillain-Barre syndrome. In: Ropper AH (ed). Neurological and Neurosurgical Intensive Care. 3d ed. New York: Raven Press, 1993: 363–382.

    Google Scholar 

  74. Fausett MB, Vogtlander M, Lee RM, et al. Heparin-induced thrombocytopenia is rare in pregnancy. Am. J. Obstet. Gynecol. 2001; 185: 148–152.

    Article  PubMed  CAS  Google Scholar 

  75. Mc Phedran P. Venous thromboembolism during pregnancy. In: Burrow GN, Duffy TP (eds). Medical Complications During Pregnancy. Philadelphia: WB Saunders, 1999: 97–109.

    Google Scholar 

  76. Bazzan M, Donvito V. Low-molecular-weight heparin during pregnancy. Thromb. Res. 2001; 101: V175–V186.

    Article  PubMed  CAS  Google Scholar 

  77. Jaigobin C, Silver FL. Stroke and pregnancy. Stroke 2000; 31: 2948–2951.

    Article  PubMed  CAS  Google Scholar 

  78. Mas JL, Lamy C. Stroke in pregnancy and the puerperium. J. Neurol. 1998; 245: 305–313.

    Article  PubMed  CAS  Google Scholar 

  79. Wiebers DO, Whisnant JP. The incidence of stroke among pregnant women in Rochester, Minn, 1955 through 1979. JAMA 1985; 254: 3055–3057.

    Google Scholar 

  80. Sharshar T, Lamy C, Mas JL. Incidence and causes of strokes associated with pregnancy and puerperium. A study in public hospitals of Ile de France. Stroke in Pregnancy Study Group. Stroke 1995; 26: 930–936.

    Article  PubMed  CAS  Google Scholar 

  81. Kittner SJ, Stern BJ, Feeser BR, et al. Pregnancy and the risk of stroke. N. Engl. J. Med. 1996; 335: 768–774.

    Article  PubMed  CAS  Google Scholar 

  82. Ursell MR, Marras CL, Farb R, Rowed DW, Black SE, Perry JR. Recurrent intracranial hemorrhage due to postpartum cerebral angiopathy: Implications for management. Stroke 1998; 29: 1995–1998.

    Article  PubMed  CAS  Google Scholar 

  83. Out HJ, Bruinse HW, Christiaens GC, et al. A prospective, controlled multicenter study on the obstetric risks of pregnant women with antiphospholipid antibodies. Am. J. Obstet. Gynecol. 1992; 167: 26–32.

    PubMed  CAS  Google Scholar 

  84. Turrentine MA, Braems G, Ramirez MM. Use of thrombolytics for the treatment of thromboembolic disease during pregnancy. Obstet. Gynecol. Surv. 1995; 50: 534–541.

    Article  PubMed  CAS  Google Scholar 

  85. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rtPA Stroke Study Group. N. Engl. J. Med. 1995; 333: 1581–1587.

    Article  Google Scholar 

  86. CLASP: A randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. Lancet 1994; 343: 619–629.

    Article  Google Scholar 

  87. Lamy C, Hamon JB, Coste J, Mas JL. Ischemic stroke in young women: risk of recurrence during subsequent pregnancies. French Study Group on Stroke in Pregnancy. Neurology 2000; 55: 269–274.

    Article  PubMed  CAS  Google Scholar 

  88. Dias MS, Sekhar LN. Intracranial hemorrhage from aneurysms and arteriovenous malformations during pregnancy and the puerperium. Neurosurgery 1990;27:855–865; discussion 865–866.

    Google Scholar 

  89. Hunt HB, Schifrin BS, Suzuki K. Ruptured berry aneurysms and pregnancy. Obstet. Gynecol. 1974; 43: 827–837.

    PubMed  CAS  Google Scholar 

  90. Robinson JL, Hall CS, Sedzimir CB. Arteriovenous malformations, aneurysms, and pregnancy. J. Neurosurg. 1974; 41: 63–70.

    Article  PubMed  CAS  Google Scholar 

  91. Horton JC, Chambers WA, Lyons SL, Adams RD, Kjellberg RN. Pregnancy and the risk of hemorrhage from cerebral arteriovenous malformations. Neurosurgery 1990;27:867–871; discussion 871–872.

    Google Scholar 

  92. Meyers PM, Halbach VV, Malek AM, et al. Endovascular treatment of cerebral artery aneurysms during pregnancy: Report of three cases. AJNR 2000; 21: 1306–1311.

    PubMed  CAS  Google Scholar 

  93. Raps EC, Galetta SL, Flamm ES. Neuro-intensive care of the pregnant woman. Neurol. Clin. 1994; 12: 601–611.

    PubMed  CAS  Google Scholar 

  94. Lamy C, Sharshar T, Mas J. Pathologie vasculaire cerebrale au cours de la grossesse et du post-partum. Rev. Neurol. (Paris) 1996; 152: 422–440.

    CAS  Google Scholar 

  95. Cantu C, Barinagarrementeria F. Cerebral venous thrombosis associated with pregnancy and puerperium. Review of 67 cases. Stroke 1993; 24: 1880–1884.

    Article  PubMed  CAS  Google Scholar 

  96. Srinivasan K. Cerebral venous and arterial thrombosis in pregnancy and puerperium. A study of 135 patients. Angiology 1983; 34: 731–746.

    Article  PubMed  CAS  Google Scholar 

  97. Donaldson J. Neurologic complications. In: Burrow G, Duffy T (eds). Medical Complications During Pregnancy. 5th ed. Philadelphia: WB Saunders, 1999: 401–414.

    Google Scholar 

  98. Donaldson JO, Lee NS. Arterial and venous stroke associated with pregnancy. Neurol. Clin. 1994; 12: 583–599.

    PubMed  CAS  Google Scholar 

  99. Bousser MG. Cerebral venous thrombosis: Nothing, heparin, or local thrombolysis ? Stroke 1999; 30: 481–483.

    Article  PubMed  CAS  Google Scholar 

  100. Einhaupl KM, Villringer A, Meister W, et al. Heparin treatment in sinus venous thrombosis. Lancet 1991; 338: 597–600.

    Article  PubMed  CAS  Google Scholar 

  101. de Bruijn SF, Stam J. Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. Stroke 1999; 30: 484–488.

    Article  PubMed  Google Scholar 

  102. Srinivasan K. Puerperal cerebral venous and arterial thrombosis. Semin. Neurol. 1988; 8: 222–225.

    Article  PubMed  CAS  Google Scholar 

  103. Frey JL, Muro GJ, McDougall CG, Dean BL, Jahnke HK. Cerebral venous thrombosis: Combined intrathrombus rtPA and intravenous heparin. Stroke 1999; 30: 489–494.

    Article  PubMed  CAS  Google Scholar 

  104. Onesti ST, Wisniewski T, Post KD. Clinical versus subclinical pituitary apoplexy: Presentation, surgical management, and outcome in 21 patients. Neurosurgery 1990; 26: 980–986.

    Article  PubMed  CAS  Google Scholar 

  105. Nagulesparan M, Roper J. Haemorrhage into the anterior pituitary during pregnancy after induction of ovulation with clomiphene. Br. J. Obstet. Gynaecol. 1978; 85: 153–155.

    Article  PubMed  CAS  Google Scholar 

  106. Lunardi P, Rocchi G, Rizzo A, Missori P. Neurinoma of the oculomotor nerve. Clin. Neurol. Neurosurg. 1990; 92: 333–335.

    Article  PubMed  CAS  Google Scholar 

  107. Hervet E, Barrat J, Pigne A, Darbois Y, Faguer C. [Prolactin adenoma. Hypophysectomy during pregnancy]. Nouv. Presse Med. 1975; 4: 2393–2395.

    PubMed  CAS  Google Scholar 

  108. O’Donovan PA, O’Donovan PJ, Ritchie EH, Feely M, Jenkins DM. Apoplexy into a prolactin secreting macroadenoma during early pregnancy with successful outcome. Case report. Br. J. Obstet. Gynaecol. 1986; 93: 389–391.

    PubMed  Google Scholar 

  109. Rolih C, Ober K. Pituitary apoplexy. Endocrinol. Metabol. Clin. North Am. 1993; 22: 291–302.

    CAS  Google Scholar 

  110. Oyesiku N. Pituitary tumors and Sheehan’s syndrome in pregnant women. In: Loftus C (ed). Neurosurgical Aspects of Pregnancy: AANS, Rolling Meadows, IL, 1996: 77–84.

    Google Scholar 

  111. Schmidt D, Canger R, Avanzini G, et al. Change of seizure frequency in pregnant epileptic women. J. Neurol. Neurosurg. Psychiatry 1983; 46: 751–755.

    Article  PubMed  CAS  Google Scholar 

  112. Knight AH, Rhind EG. Epilepsy and pregnancy: A study of 153 pregnancies in 59 patients. Epilepsia 1975; 16: 99–110.

    Article  PubMed  CAS  Google Scholar 

  113. Licht EA, Sankar R. Status epilepticus during pregnancy. A case report. J. Reprod. Med. 1999; 44: 370–372.

    PubMed  CAS  Google Scholar 

  114. Michalsen A, Henze T, Wagner D, Schillinger H, Engels K. [Status epilepticus late in pregnancy—eclampsia or subarachnoid hemorrhage?]. Anasthesiol. Intensivmed. Notfallmed. Schmerzther. 1997; 32: 380–384.

    Article  PubMed  CAS  Google Scholar 

  115. Morrell MJ. The new antiepileptic drugs and women: Efficacy, reproductive health, pregnancy, and fetal outcome. Epilepsia 1996; 37: S34–S44.

    Article  PubMed  CAS  Google Scholar 

  116. Lander CM, Eadie MJ. Plasma antiepileptic drug concentrations during pregnancy. Epilepsia 1991; 32: 257–266.

    Article  PubMed  CAS  Google Scholar 

  117. Nau H, Helge H, Luck W. Valproic acid in the perinatal period: decreased maternal serum protein binding results in fetal accumulation and neonatal displacement of the drug and some metabolites. J. Pediatr. 1984; 104: 627–634.

    Article  PubMed  CAS  Google Scholar 

  118. Yerby MS, Friel PN, McCormick K. Antiepileptic drug disposition during pregnancy. Neurology 1992; 42: 12–16.

    PubMed  CAS  Google Scholar 

  119. Yerby MS, Friel PN, McCormick K, et al. Pharmacokinetics of anticonvulsants in pregnancy: alterations in plasma protein binding. Epilepsy Res. 1990; 5: 223–228.

    Article  PubMed  CAS  Google Scholar 

  120. Goetting MG, Davidson BN. Status epilepticus during labor. A case report. J. Reprod. Med. 1987; 32: 313–314.

    PubMed  CAS  Google Scholar 

  121. Teramo K, Hiilesmaa V. Pregnancy and fetal complications in epileptic pregnancies: Review of the literature. In: Janz D (ed). Epilepsy, Pregnancy and the Child. New York: Raven Press, 1982: 53–59.

    Google Scholar 

  122. Varelas PN, Mirski MA. Seizures in the adult intensive care unit. J. Neurosurg. Anesthesiol. 2001; 13: 163–175.

    Article  PubMed  CAS  Google Scholar 

  123. Dalessio DJ. Current concepts. Seizure disorders and pregnancy. N. Engl. J. Med. 1985; 312: 559–563.

    Article  PubMed  CAS  Google Scholar 

  124. Ryan G, Lange IR, Naugler MA. Clinical experience with phenytoin prophylaxis in severe preeclampsia. Am. J. Obstet. Gynecol. 1989; 161: 1297–1304.

    PubMed  CAS  Google Scholar 

  125. Spike J. Brain death, pregnancy, and posthumous motherhood. J. Clin. Ethics 1999; 10: 57–65.

    PubMed  CAS  Google Scholar 

  126. Dillon WP, Lee RV, Tronolone MJ, Buckwald S, Foote RJ. Life support and maternal death during pregnancy. JAMA 1982; 248: 1089–1091.

    Article  PubMed  CAS  Google Scholar 

  127. Field DR, Gates EA, Creasy RK, Jonsen AR, Laros RK, Jr. Maternal brain death during pregnancy. Medical and ethical issues. JAMA 1988; 260: 816–822.

    Article  PubMed  CAS  Google Scholar 

  128. Bernstein IM, Watson M, Simmons GM, Catalano PM, Davis G, Collins R. Maternal brain death and prolonged fetal survival. Obstet. Gynecol. 1989; 74: 434–437.

    Google Scholar 

  129. Catanzarite VA, Willms DC, Holdy KE, Gardner SE, Ludwig DM, Cousins LM. Brain death during pregnancy: Tocolytic therapy and aggressive maternal support on behalf of the fetus. Am. J. Perinatol. 1997; 14: 431–434.

    Article  PubMed  CAS  Google Scholar 

  130. Varelas P, Fayad P. Migraine and stroke. In: Cohen S (ed). Management of Ischemic Stroke. New York: Mc Graw-Hill, 2000: 391–404.

    Google Scholar 

  131. Bodis L, Szupera Z, Pierantozzi M, et al. Neurological complications of pregnancy. J. Neurol. Sci. 1998; 153: 279–293.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Panayiotis N. Varelas
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  2. Lotfi Hacein-Bey
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Editors and Affiliations

  1. Neurosciences Critical Care, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA

    Jose I. Suarez MD

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© 2004 Springer Science+Business Media New York

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Varelas, P.N., Hacein-Bey, L. (2004). Neurocritical Care During Pregnancy and Puerperium. In: Suarez, J.I. (eds) Critical Care Neurology and Neurosurgery. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-660-7_32

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  • DOI: https://doi.org/10.1007/978-1-59259-660-7_32

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-350-3

  • Online ISBN: 978-1-59259-660-7

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