Management of Eclampsia and Stroke During Pregnancy
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概要
- 論文の詳細を見る
To establish the etiologies and therapeutic strategies for the treatment of eclampsia and stroke during pregnancy, we performed a questionnaire-based study of stroke during pregnancy in Aichi prefecture (2005-2009). This study revealed the following findings: 66% of deliveries were managed in primary medical institutions, 40% of eclampsia episodes and 31% of strokes occurred at primary medical institutions, and 19% of strokes occurred at home. Home-onset strokes displayed a mortality rate of 40%. Using the results of this questionnaire, we investigated cases of eclampsia and/or stroke during pregnancy and revealed important issues regarding their management. In pregnant women with eclampsia or stroke, accurate antihypertensive and anticonvulsive treatment are necessary. Discriminating between eclampsia and stroke during labor is difficult. However, when facial or arm muscle weakness or a facial deficit is detected, stroke should be strongly suspected. Brain computed tomography can usually detect most cases of hemorrhagic stroke. When a stroke is detected, collaborative treatment with a neurosurgeon should be started as soon as possible. If stroke is suspected at a primary medical institution, rapid maternal transport to an intensive medical institution is necessary. In patients whose blood pressure is greater than 180/120 mmHg, the use of MgSO4 to decrease the risk of convulsions and reduce blood pressure is recommended. These findings might aid the development of therapeutic strategies for pregnant women with eclampsia or stroke.
著者
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Kikkawa Fumitaka
Department Of Gynecology And Obstetrics Nagoya University Graduate School Of Medicine
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Kawai Michiyasu
Department Of Obstetrics And Gynecology Toyohashi Municipal Hospital
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Sakakibara Katsumi
Department Of Communication Engineering Okayama Prefectural University
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Tanaka Kanji
Department Of Obstetrics And Gynecology Hirosaki University School Of Medicine
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Ishikawa Kaoru
Department Of Gynecology And Obstetrics Japanese Red Cross Nagoya First Hospital
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KIKKAWA Fumitaka
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine
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KAWAI Michiyasu
Department of Obstetrics and Gynecology, Toyohashi Municipal Hospital
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MORIKAWA Shigehiko
Department of Obstetrics and Gynecology, Komaki Municipal Hospital
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TANAKA Kanji
Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine
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OHNO Yasumasa
Ohno Ladies Clinic
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SAKAKIBARA Katsumi
Department of Obstetrics and Gynecology, Okazaki Municipal Hospital
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Sakakibara Katsumi
Department of Chemistry, Faculty of Science, Nagoya University
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TANAKA Kanji
Department of Human & Artifitial Intelligence Systems, Faculty of Engineering, Univ. of Fukui
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