Cerebral Vascular Accident in Young Women: A Problem for Pregnancy and Contraception? Report of Two Cases

Fernandes ALM¹, Araujo AHSL¹, Fonseca CC¹, Pinto CDC¹, Mata DS¹, Pacheco GAN¹, Sant-Ana GMC¹, Barbosa INL¹, Barreto IC¹, Gribel LH¹, Resende LAF¹, Faria LP¹, Silva LFF¹, Caplum MC¹, Luz MS¹, Mourão PA¹, Amaral VM1, Zimmermann JB^2,3,4,5*
1Gynecology and Obstetrics Service, Barbacena School of Medicine (FUNJOBE), Barbacena, Minas Gerais State, Brazil
²Medical School of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais State, Brazil
³Healthcare Center of the University Hospital, Medical School of Federal University of Juiz de Fora, Obstetrics service, Brazil
⁴High-Risk Prenatal Care, Brazil
⁵Zimmermmann Obstetrics and Gynecology Clinic, Brazil

Corresponding Author: Juliana Barroso Zimmermmann ^{ORCID ID}
Address: Gynecology and Obstetrics Service, Barbacena School of Medicine (FUNJOBE), Barbacena, Minas Gerais State, Brazil.
Received date: 28 June 2020; Accepted date: 15 August 2020; Published date: 28 August 2020

Citation: Fernandes ALM, Araujo AHSL, Fonseca CC, Pinto CDC, Mata DS, Pacheco GAN, Sant-Ana GMC, Barbosa INL, Barreto IC, Gribel LH, Resende LAF, Faria LP, Silva LFF, Caplum MC, Luz MS, Mourão PA, Amaral VM, Zimmermann JB. Cerebral Vascular Accident in Young Women: A Problem for Pregnancy and Contraception? Report of Two Cases. Asp Biomed Clin Case Rep. 2020 Aug 28;3(3):178-85.

Copyright © 2020 Fernandes ALM, Araujo AHSL, Fonseca CC, Pinto CDC, Mata DS, Pacheco GAN, Sant-Ana GMC, Barbosa INL, Barreto IC, Gribel LH, Resende LAF, Faria LP, Silva LFF, Caplum MC, Luz MS, Mourão PA, Amaral VM, Zimmermann JB. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Cerebrovascular Disease, Stroke, Eclampsia, Pregnancy, Hemorrhagic, Ischemic

Abstract

Cerebrovascular disease (CVD) is a neurological medical emergency and one of the main causes of death worldwide; it is classified as ischemic or hemorrhagic. The disease is one of the most severe clinical events related to pregnancy due to thrombogenesis and thrombophilia; there is an incidence of 25 to 34 CVD per 100 thousand births. The current research reports two cases of stroke episode, one previous and another during pregnancy, as well as their associated complications. The first patient had hereditary thrombophilia caused by PAI 4G/5G polymorphism and previous stroke; however, she had regular pregnancy. The second patient had hereditary thrombophilia caused by protein C deficit, had a stroke during pregnancy, and preeclampsia in the first gestational semester; therefore, she was subjected to the cesarean section on the 35^th week of pregnancy. Stroke episodes during pregnancy can be very aggressive because it can lead to death or disabilities, not only in the mother but also in the fetus. Based on the association between thrombotic processes and complications, prophylactic anticoagulant therapy is recommended for women with thrombophilia who had a stroke and/or certain adverse pregnancy outcomes, such as recurrent miscarriages.