Stroke in a Retrospective Cohort of Patients with Eclampsia

Aims: To identify the incidence, vascular origin, type and outcome of stroke in a retrospective cohort of patients with eclampsia.

Study Design: Cross-sectional, retrospective and analytical study.

Place and Duration of Study: Intensive Care Unit (ICU), High Specialty Medical Unit of Gynecology and Obstetrics Hospital No. 3, National Medical Center "La Raza", Mexican Institute of Social Security, Mexico City between January 1, 2019 to December 31, 2022.

Methodology: The research was carried out in a retrospective cohort of 43 patients with eclampsia admitted to the ICU. The clinical record, Cranial Tomography (CT), and Magnetic Resonance Imaging (MRI) findings were consulted to determine the incidence, vascular origin, type and outcome of the stroke. ICU stay and patient mortality were reported. Data were analyzed with descriptive and inferential statistics (Kolmogorov–Smirnov test, chi-square, paired Student's t-test, Mann-Whitney-Wilcoxon U test). The value P < 0.05 was significant.

Results: Incidence of stroke 27.90% (n=12/43). Findings by CT 41.66% (n=5) and CT with MRI 58.34% (n=7). Vascular origin: arterial 58.34% (n=7), arterial-venous 33.33% (n=4) and venous 8.33% (n=1). Type of stroke: arterial hemorrhagic 50% (n=6), arterial ischemic 58.33% (n=7), subarachnoid hemorrhage 25% (n=3) and venous thrombosis 41.66% (n=5). Presentation: solitary stroke 58.33% and combinations 41.66% (proportion 1.4). Management in the same hospital 58.33% (n=7) and transfers to highly specialized units for serious complications 41.67% (n=5). ICU stay 3.95±1.82 days, it was similar in patients with and without stroke (p=0.226). Maternal mortality 0%.

Conclusion: The incidence of stroke was very high with extremely severe lesions, but without effect on ICU stay and mortality. Team management was necessary in a high percentage of cases.