Anderson Annika, Singh Jessica, Bove Riley
Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.
Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States; Department of Neurology, School of Medicine, University of California San Francisco, San Francisco, CA, United States.
Handb Clin Neurol. 2020;171:179-191. doi: 10.1016/B978-0-444-64239-4.00009-6.
Physiologic changes occurring in pregnancy and postpartum can have secondary effects on the maternal nervous system. While most alterations to neurologic function during pregnancy are transient, there is an elevated risk for more serious complication in the peripartum period, such as cerebrovascular events or exacerbation of preexisting neurologic conditions. Due to the morbidity and mortality associated with these neurologic manifestations in some cases, timely diagnostic evaluation is essential. In the pregnant population, the use of diagnostic techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), commonly employed to evaluate emergent neurologic abnormalities, requires special consideration of the potential risks associated with prenatal exposure. This review discusses several neurologic conditions affecting women during pregnancy for which diagnostic imaging may be warranted. Concerns relating to CT and MRI procedures, radiation exposure in utero, and exposure to intravenous contrast by placental transfer and breastfeeding are also reviewed.
妊娠和产后发生的生理变化会对母体神经系统产生继发影响。虽然孕期神经功能的大多数改变是暂时的，但围产期出现更严重并发症的风险会升高，如脑血管事件或既往存在的神经疾病加重。由于在某些情况下这些神经表现会导致发病和死亡，及时进行诊断评估至关重要。在孕妇群体中，常用于评估紧急神经异常的诊断技术，如计算机断层扫描（CT）和磁共振成像（MRI），需要特别考虑与产前暴露相关的潜在风险。本综述讨论了几种孕期影响女性的神经疾病，对于这些疾病可能有必要进行诊断性影像学检查。还综述了与CT和MRI检查程序、子宫内辐射暴露以及通过胎盘转运和母乳喂养接触静脉造影剂有关的问题。
