Department of Neurology, Wagner-Jauregg Neuroscience Centre, Wagner-Jauregg-Weg 15, 4020 Linz, Austria.
Best Pract Res Clin Obstet Gynaecol. 2013 Dec;27(6):867-75. doi: 10.1016/j.bpobgyn.2013.07.007. Epub 2013 Aug 27.
Neurological conditions during pregnancy can be pregnancy related or can be caused by exacerbation of pre-existing neurological disorders. Knowledge of pre-existing epilepsy or myasthenia gravis in women of childbearing age requires preconception counselling by neurologist and planned pregnancy. Possible adverse effects of medication on the foetus should be balanced with the risk of uncontrolled symptoms. Interdisciplinary management before, during and after pregnancy is recommended. New acute neurological symptoms in pregnant or postpartum women should lead to an urgent neurological review. Patients need a thorough diagnostic evaluation that targets a range of serious pathological conditions that are either unique to (e.g. eclampsia) or arise more frequently (e.g. cerebral venous thrombosis) in this population. Most of these conditions are infrequent and require a specialized and multidisciplinary management. Treatment is challenging due to risks to the unborn child.
妊娠期间的神经系统疾病可能与妊娠相关,也可能由原有神经系统疾病恶化引起。对于育龄期妇女,如果存在已知的癫痫或重症肌无力,应由神经科医生进行孕前咨询和计划妊娠。药物对胎儿的可能不良影响应与未控制症状的风险相平衡。建议在妊娠前、妊娠期间和妊娠后进行多学科管理。妊娠或产后新发急性神经系统症状应立即进行神经科评估。患者需要进行全面的诊断评估,以针对这一人群中特有的(如子痫)或更常见的(如脑静脉血栓形成)一系列严重病理情况进行靶向治疗。这些情况大多较为罕见,需要专业和多学科的管理。由于对胎儿有风险,治疗具有挑战性。