Transient Ischaemic Attack in Pregnancy: Case Report

JOURNAL TITLE: Journal of Obstetric and Gynaecological Practices POGS

Author
1. Kshama Nilesh Uplenchwar
2. Sundas Butt
3. Aparna Kulkarni
4. Rupali Banzal
5. Anirudhdha Joshi
ISSN
DOI
10.5005/jogyp-11012-0008
Volume
1
Issue
1
Publishing Year
2023
Pages
2
Author Affiliations
    1. Department of Obstetrics and Gynaecology, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India
    1. Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
    1. Queen\'s Medical Centre, Nottingham, United Kingdom
    1. Department of Fetal Medicine, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India
    1. Department of Radiology, Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India
  • Article keywords
    Low molecular weight-heparin, Neurological symptoms, Pregnancy, Stroke in pregnancy, Transient Ischaemic Attack

    Abstract

    Aim and background: The incidence of stroke in pregnancy is 10–34 per 100000 deliveries. In 15% of cases, stroke is preceded by a transient ischaemic attack (TIA). Prevention of stroke, appropriate fetal monitoring, and timely delivery can lead to successful maternal and neonatal outcomes. Case description: We present a case,. where a mother was treated for TIA and the fetal Doppler was repeated every 72 hours to look for reflection of cerebral vascular events in the placental vasculature. Doppler enabled timely delivery resulting in successful maternal and neonatal outcomes. Conclusion: A 26-year-old, low-risk primigravida with 31 weeks pregnancy was referred with a history of sudden onset heaviness in her head, tingling and numbness, inability to lift left upper limb, and difficulty in speaking for 30 minutes. Magnetic resonance imaging (MRI) was suggestive of linear acute infarcts in sub-cortical white matter in the right superior frontal lobe and parietal lobe. Dopplers were repeated every 72 hours. Stoke was prevented by a therapeutic dose of Low molecular weight-heparin (LMWH) daily. Decision to deliver was guided by derangement in fetal Doppler when Cerebro placental ratio deranged to less than one, leading to a successful maternal and neonatal outcomes.

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