Acute Ischemic Stroke in the Postpartum Period

Abstract

During pregnancy and delivery, the risk of cerebrovascular disorders increases due to several physiological changes. The elevated level of estrogen stimulates the production of clotting factors, which deteriorates the risk of thromboembolism. Increased plasma volume and total blood volume lead to the risk of hypertension, and the high level of progesterone in the third trimester of pregnancy promotes the permeability of small blood vessels. The risk of developing cerebrovascular complications remains high in the postpartum period. The article describes two clinical cases of postpartum ischemic stroke as a complication after surgical delivery in young women with an aggravated somatic medical history. The treatment and follow-up of these patients during their stay in the intensive care unit included changes in management tactics, use of antiplatelet, anticoagulant, and metabolic therapy, and subsequent rehabilitation. This article describes the case-management interventions and changes in neurological symptoms of these patients, also it discusses the most likely etiological factors of cerebrovascular disorders in these cases

Keywords

• acute cerebral circulatory disorders
• stroke
• preeclampsia
• hypertensive disorders
• regional anesthesia
• combined spinal-epidural anesthesia
• pregnancy
• cesarean section