Association of Primary Intracerebral Hemorrhage With Pregnan
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Intracerebral hemorrhage (ICH) during pregnancy and the postpartum period results in catastrophic maternal outcomes. There is a paucity of population-based estimates of pregnancy-related ICH risk, including risk during the extended postpartum period.

This study found that the risk of nontraumatic ICH is increased during pregnancy and the postpartum period. The elevated risk of ICH was highest during the third trimester and the first 12 weeks of the postpartum period.

An elevated ICH risk was observed in the first 12 weeks of the postpartum period, rather than the traditional 6-week postpartum period. To our knowledge, ICH risk during an extended postpartum period has not been evaluated previously, even though there are prior reports of an elevated risk of thromboembolic events beyond the conventional postpartum time period. These findings support the updated guidelines for postpartum care to be considered a care continuum, rather than a single postpartum visit at 6 weeks, similar to monitoring recommendations for peripartum cardiomyopathy. For patients with elevated risk profiles, such as those with hypertension or preeclampsia, the need for close, continued follow-up post partum should be emphasized.

These findings suggest that the risk of ICH is significantly higher during the third trimester of pregnancy and the first 12 weeks postpartum. There are age and race disparities in ICH risk that are associated with devastating maternal and fetal outcomes. Data illustrate the critical need for continuous monitoring and aggressive management of ICH-associated risk factors. These findings suggest that extended postpartum monitoring of high-risk women may be warranted.

Source:https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2764376
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