HEMORRHAGIC STROKE IN MULTIGRAVIDA WOMAN WITH SEVERE PREECLAMPSIA: A CASE REPORT

1Tgk. Chairannisa Putri, *Rajuddin, Roziana, Sarah Ika, Ika Marlia

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Abstract:

Hemorrhagic stroke is one of the big problems in pregnancy. When this condition occurs, both the mother and baby are in dangerous conditions and will be a bad outcome. Stroke incidence in pregnancy estimated to reach 4 to 34,2 per 100,000 births and the mortality rate is 1.4 per 100,000 births. Causes of the intracerebral hemorrhage (ICH) including vascular anomalies, severe preeclampsia, eclampsia, and coagulopathy.Provide an overview related to the incidence, comorbidities, and choices and considerations in the management of hemorrhagic strokes in pregnancy.We report a 34 years old multigravida woman 33-34 weeks gestational age with a chief complaint of weakness of right extremities, headache, and slurred speech with high blood pressure and found proteinuria from urinalysis examination. On obstetric ultrasound examination found singleton live head presentation baby according 33-34 weeks gestational age with estimated fetal weight 1860 grams. Head CT scan examination showed small amount of blood filling in frontoparietal left lobe with estimated volume about 21 cc with a conclusion as a subarachnoid hemorrhage (SAH). Patients got early management of preeclampsia until MAP reached, and performed emergency cesarean section to terminated the pregnancy because of the worsening of the mother such as severe headache, nausea and vomitus. Patients and baby were in good condition and discharged after being treated at the NICU and mother plans to physiotherapy after recovery post operation.Spontaneous hemorrhagic stroke will give a high rate of maternal mortality but subarachnoid hemorrhage is a condition that is less common. Preeclampsia is a risk factor and a co-morbid for this condition. The diagnosis and management of hemorrhagic stroke is not much different during pregnancy. Care for mother with spontaneous ICH at the time of termination of pregnancy is very individual. However, what is most important for maternal and fetal care is the optimization of the mother and childbirth for the obstetric indications that are needed. Management in the third trimester of pregnancy must be considered to avoid prematurity as long as the neurological and obstetric status is stable

Keywords:

Hemorrhagic Stroke, Severe Preeclampsia, Subarachnoid Hemorrhage

Paper Details
Month4
Year2020
Volume24
IssueSpecial Issue 2
Pages242-247