Risk of recurrent cervical artery dissection during pregnancy, childbirth and puerperium. (29th November 2014)

• Record Type: Journal Article
• Authors: Reinhard, M.; Munz, M.; von Kannen, A.‐L.; Griesser‐Leute, H.‐J.; Dittrich, R.; Engelter, S. T.
• Is Part Of: European journal of neurology. Volume 22:Number 4(2015:Apr.)
• Page Start: 736
• Page End: 739
• Publication Date: 2014-11-29
• Subjects: Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.12602
• Languages: English
• ISSNs: 1351-5101

Abstract

<abstract abstract-type="main" id="ene12602-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ene12602-sec-0001" sec-type="section"> <title>Background and purpose</title> <p>Hormonal and mechanical factors might increase the risk for cervical artery dissection (CAD) during pregnancy and the puerperium. There is uncertainty how to counsel women with a previous CAD regarding the risk of CAD recurrence during pregnancy and the puerperium.</p> </sec> <sec id="ene12602-sec-0002" sec-type="section"> <title>Methods</title> <p>In an observational study of four stroke centers, all women aged 16–45 years with primary CAD in the previous decade were asked to participate in a standardized assessment on long‐term follow‐up with a special focus on pregnancies and recurrent CAD.</p> </sec> <sec id="ene12602-sec-0003" sec-type="section"> <title>Results</title> <p>Ninety‐two women were identified and 53 of them were included in the analysis (60%). Eleven women declined to participate, 28 were untraceable. The 39 non‐participants did not differ from participants regarding key baseline characteristics. Average follow‐up time was 72 months. Nine women (17%) had recurrent CAD after a median of 14 days (range 2 days to 117 months). Eleven women (20%) had a total of 13 completed pregnancies at a median of 44 months (range 12–84 months) after index CAD. Two of the pregnant women (18%) had suffered recurrent CAD ≥18 months prior to the pregnancy. All 13 pregnancies and puerperia went without recurrent CADs or cerebrovascular events. This includes giving birth by vaginal delivery (<italic>n</italic> = 6) and caesarean section (<italic>n</italic> = 7). None of the five women with typical connective tissue disease became pregnant.</p> </sec> <sec id="ene12602-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Our observation suggests that the risk of recurrent CAD may not be greatly increased with pregnancies starting at least 12 months after CAD in women without typical connective tissue disease.</p> </sec> </abstract>