STROKE AND PREGNANCY: THE MAIN RISK FACTORS

Purpose. To identify risk factors for the development of acute cerebral circulatory impairments (ACCI) in pregnant women.

Materials and methods. The material for the study was the medical history of 31 pregnant women with diagnosis ACCI. The average age was 29,5 ± 5,1 years. The comparison group consisted of pregnant women with physiological pregnancy (n = 30) with different gestation periods, the mean age was 29,1 ± 6,7 years. In this study, a comparative analysis of risk factors for stroke was carried out: gynecological and allergic history, smoking and taking contraceptives, the presence of chronic diseases, indicators of the hemostasis and lipid spectrum, polymorphism of thrombophilia genes.

Results. The prevalence of ischemic stroke over hemorrhagic stroke was found, which was 77.4% and 22.6%, respectively. In 93.5% of cases, a stroke occurred during pregnancy, in 79.3% of them in the third trimester of gestation. The number of recuperated women was 67.7%. As a result of statistical treatment, a significant difference in study and comparison groups was obtained (p < 0.05) as a result of a burdened obstetric-gynecological history. Among the women taking contraceptives, 11 (35.5%) women were in the study group, and 3 (10%) women were found in the comparison group (p < 0.05). At the analysis of smoking in the history the number of women in the study group prevailed comparing to the comparison group (35.5–13.3%, p < 0.05). Changes in the lipid spectrum system and hemostasis were detected, but there were no significant differences between the study group and the comparison group (p> 0.05). Various forms of mutations were identified in the group with ischemic stroke in 14 (58.3%) women, in 2 (28.5%) women in the group with hemorrhagic stroke.

Conclusion. Of all the data analyzed in pregnant women with stroke, statistically significant risk factors are: smoking, taking contraceptives, the presence of chronic diseases, including an obstructed obstetric-gynecological anamnesis. Primary and secondary preventive measures will depend on the availability of a particular risk factor.

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