妊娠和产后期卒中的危险因素

Risk factors for stroke in pregnancy and the postpartum period

妊娠和产后期女性的卒中风险增高，尤其是在妊娠末期和产后期，虽然发生率较低，但严重威胁母婴安全。妊娠和产后期卒中的危险凶素主要包括先兆子痫，子痫、心源性栓塞、脑血管畸形、脑动脉瘤、血栓性血小板减少性紫癜、抗磷脂抗体综合征等。其治疗措施与非妊娠患者相似，包括溶栓、抗血小板和抗凝治疗，但需注意对孕产妇和胎儿的影响。

Pregnancy and the puerperium have been recognized to increase the risk of stroke, particularly from late pregnancy and through the puerperium. The reported incidences of stroke during pregnancy and the puerperium varied widely, but when it occurs, there may be implications for management of the patient and delivery of the child. Important causes of stroke during pregnancy and the puerperium include preeclampsia and eclampsia, cardioembolism, rupture of cerebral vascular anomaly, cerebral aneurysm rupture and antiphospholipid syndrome, thrombotic thrombocytopenic purpura. Manatgement of patients with pregnancy-related stroke is largely the same as that of nonpregnant patients, including thrombolysis, atntiplatelets and anticoagulants, with more consideration on maternal and fetal risks.