Myriam Assif1, Catherine Lamy1, Solène De Gaalon1, Yolande Caroit1, Romain Bourcier1, Cécile Preterre1, Benoit Guillon1. 1. Stroke Unit (MA, SDG, CP, BG), Nantes University Hospital; Department of Neurology (CL), Paris Descartes University, Hôpital Sainte-Anne, Paris; Department of Obstetrics and Gynecology (YC), Nantes University Hospital; Department of Neuroradiology (RB), Nantes University Hospital, France.
Abstract
OBJECTIVES: To assess the risk of recurrence of cervical artery dissection (CAD) during pregnancy and puerperium in women with a history of CAD and then help physicians with providing medical information to women who wish to become pregnant. METHODS: Women aged 16-45 years who were admitted to our center for a CAD between 2005 and 2017 were identified from the hospital database, and those with spontaneous and symptomatic CAD were included. They were then contacted to answer a questionnaire that was specifically designed in regard to the recurrence of CAD and pregnancies after the primary CAD. RESULTS: Ninety-one patients satisfied our inclusion criteria, and 89 were included in the analysis. During a median follow-up of 7.0 years, 4 women (4.4%) had recurrent CAD, although none during pregnancy or puerperium. Eighteen women (20%) had a total of 20 full-term pregnancies, occurring at least 6 months after CAD. Of these 20 pregnancies, 13 (65%) were vaginal deliveries, and 7 (35%) were cesarean sections. The reason for the absence of pregnancies after the initial CAD was unrelated to the vascular event in 89% of cases, but 8% of the women had been advised by a physician to avoid any future pregnancy or they had been recommended to undergo abortion or sterilization. CONCLUSION: In this study, there were no CAD recurrences during subsequent pregnancies or postpartum, irrespective of the type of delivery. Thus, pregnancy after a history of CAD appears to be safe.
OBJECTIVES: To assess the risk of recurrence of cervical artery dissection (CAD) during pregnancy and puerperium in women with a history of CAD and then help physicians with providing medical information to women who wish to become pregnant. METHODS: Women aged 16-45 years who were admitted to our center for a CAD between 2005 and 2017 were identified from the hospital database, and those with spontaneous and symptomatic CAD were included. They were then contacted to answer a questionnaire that was specifically designed in regard to the recurrence of CAD and pregnancies after the primary CAD. RESULTS: Ninety-one patients satisfied our inclusion criteria, and 89 were included in the analysis. During a median follow-up of 7.0 years, 4 women (4.4%) had recurrent CAD, although none during pregnancy or puerperium. Eighteen women (20%) had a total of 20 full-term pregnancies, occurring at least 6 months after CAD. Of these 20 pregnancies, 13 (65%) were vaginal deliveries, and 7 (35%) were cesarean sections. The reason for the absence of pregnancies after the initial CAD was unrelated to the vascular event in 89% of cases, but 8% of the women had been advised by a physician to avoid any future pregnancy or they had been recommended to undergo abortion or sterilization. CONCLUSION: In this study, there were no CAD recurrences during subsequent pregnancies or postpartum, irrespective of the type of delivery. Thus, pregnancy after a history of CAD appears to be safe.
Authors: J M de Bray; B Guillon; J P Neau; J Bouilliat; X Ducrocq; D Saudeau; D Vincent; I Penisson-Besnier; A Pasco; F Dubas Journal: Cerebrovasc Dis Date: 2000 Mar-Apr Impact factor: 2.762
Authors: N Yesilot Barlas; J Putaala; U Waje-Andreassen; S Vassilopoulou; K Nardi; C Odier; G Hofgart; S Engelter; A Burow; L Mihalka; M Kloss; J Ferrari; R Lemmens; O Coban; E Haapaniemi; N Maaijwee; L Rutten-Jacobs; A Bersano; C Cereda; P Baron; L Borellini; C Valcarenghi; L Thomassen; A J Grau; F Palm; C Urbanek; R Tuncay; A Durukan Tolvanen; E J van Dijk; F E de Leeuw; V Thijs; S Greisenegger; K Vemmos; C Lichy; D Bereczki; L Csiba; P Michel; D Leys; K Spengos; H Naess; T Tatlisumak; S Z Bahar Journal: Eur J Neurol Date: 2013-07-10 Impact factor: 6.089
Authors: A J Metso; T M Metso; S Debette; J Dallongeville; P A Lyrer; A Pezzini; C Lichy; M Kloss; T Brandt; E Touzé; A M Southerland; B B Worrall; S Abboud; E del Zotto; D Leys; S Engelter; C Grond-Ginsbach; T Tatlisumak Journal: Eur J Neurol Date: 2011-12-10 Impact factor: 6.089