Abstract
Cerebral vein thrombosis (CVT) is a rare disease usually affecting young people, especially women, with a high prevalence of thrombophilic defects. It is known that thrombophilia is associated with pregnancy complications; therefore, a high rate of complications could be expected in women with the previous CVT who become pregnant. This study examined the whole obstetric history of women who suffered from CVT to evaluate the incidence of pregnancy complications during their entire lifespan. We prospectively followed consecutive patients with CVT, limiting the analysis to females and their obstetrical history. We studied 123 pregnancies in 99 consecutive women who had a CVT; 71 women had 91 pregnancies before the CVT; 19 women had 23 pregnancies after the CVT; and nine women had a CVT related to pregnancy. All women with CVT before pregnancy were treated with LMWH at prophylactic dosage during pregnancy. No recurrent CVT, venous thromboembolic events, or death was recorded during the observed pregnancies. Ten miscarriages were recorded (rate 8.1%), with a rate similar to that expected in the general population. We confirm the favorable outcome of pregnancies in women who suffered from CVT during their entire lifespan, whether they have occurred before and after or in relation to CVT.
Similar content being viewed by others
References
Stam J (2005) Thrombosis of the cerebral veins and sinuses. N Engl J Med 352:1791–1798
Saposnik G, Barinagarrementeria F, Brown RD Jr, On behalf of the American Heart Association Stroke Council and the Council on Epidemiology and Prevention et al (2011) Diagnosis and management of cerebral venous thrombosis. Stroke 42:1158–1192
Martinelli I, Passamonti SM, Rossi E, De Stefano V (2012) Cerebral sinus-venous thrombosis. Intern Emerg Med Suppl 3:S221–S225
Ferro JM, Canhão P, Stam J et al (2004) Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 35:664–670
Dentali F, Poli D, Scoditti U et al (2012) Long-term outcomes of patients with cerebral vein thrombosis. J Thromb Haemost 10:1297–1302
Aguiar de Sousa D, Canhão P, Ferro JM (2016) Safety of pregnancy after cerebral venous thrombosis: a systematic review. Stroke 47:713–718
Rodger MA, Betancourt MT, Clark P et al (2010) The association of factor V Leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies. PLoS Med 7:e1000292
Rey E, Kahn SR, David M et al (2003) Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 361:901–908
Bamford JM, Sandercock PA, Warlow CP et al (1989) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 20:828
Tranquilli AL, Dekker G, Magee L et al (2014) The classification, diagnosis and management of the hypertensive disorders of pregnancy: a revised statement from the ISSHP. Pregnancy Hypertens. 4:97–104
Ventura SJ, Curtin SC, Abma JC et al (2012) Estimated pregnancy rates and rates of pregnancy outcomes for the United States, 1990–2008. Natl Vital Stat Rep 60:1–21
Delabaere A, Huchon C, Deffieux X et al (2014) Epidemiology of loss pregnancy. J Gynecol Obstet Biol Reprod 43:764–775
Mehraein S, Ortwein H, Busch M et al (2003) Risk of recurrence of a cerebral venous and sinus thrombosis during subsequent pregnancy and puerperium. J Neurol Neurosurg Psychiatry 74:814–816
Pourrat O, Neau JP, Pouget-Abadie JF et al (2015) Thrombosis risk during pregnancy after history of cerebral venous thrombosis. Rev Med Interne 36:10–14
Cruz-Herranz A, Illán-Gala I, Martínez-Sánchez P et al (2015) Recurrence of stroke amongst women of reproductive age: impact of and on subsequent pregnancies. Eur J Neurol 22:681-e42
Ciron J, Godenèche G, Vandamme X et al (2013) Obstetrical outcome of young women with a past history of cerebral venous thrombosis. Cerebrovasc Dis 36:55–61
Ferro JM, Lopes MG, Rosas MJ et al (2002) Long-term prognosis of cerebral vein and dural sinus thrombosis: results of the VENOPORT study. Cerebrovasc Dis 13:272–278
Preter M, Tzourio C, Ameri A et al (1996) Long-term prognosis in cerebral venous thrombosis: follow-up of 77 patients. Stroke 27:243–246
Lamy C, Hamon JB, Coste J et al (2000) Ischemic stroke in young women: risk of recurrence during subsequent pregnancies. Neurology 55:269–274
Srinivasan K (1983) Cerebral venous and arterial thrombosis in pregnancy and puerperium: a study of 135 patients. Angiology 34:731–746
Rodger MA, Betancourt MT, Clark P et al (2014) Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): a multinational open-label randomized trial. Lancet 384:1673–1683
Martin JA, Hamilton BE, Osterman MJ et al (2015) Births: final data for 2013. Natl Vital Stat Rep 64:1–65
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declared that they have no potential conflict of interest.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Funding source
None declared.
Rights and permissions
About this article
Cite this article
Poli, D., Cenci, C., Testa, S. et al. Obstetrical history of women with cerebral vein thrombosis: outcome of the pregnancies before and after the thrombotic event. Intern Emerg Med 12, 941–945 (2017). https://doi.org/10.1007/s11739-017-1682-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11739-017-1682-0