Cerebral Vascular Accident in Young Women: A Problem for Pregnancy and Contraception? Report of Two Cases

Abstract

Cerebrovascular disease (CVD) is a neurological medical emergency and one of the main causes of death worldwide; it is classified as ischemic or hemorrhagic. The disease is one of the most severe clinical events related to pregnancy due to thrombogenesis and thrombophilia; there is an incidence of 25 to 34 CVD per 100 thousand births. The current research reports two cases of stroke episode, one previous and another during pregnancy, as well as their associated complications. The first patient had hereditary thrombophilia caused by PAI 4G/5G polymorphism and previous stroke; however, she had regular pregnancy. The second patient had hereditary thrombophilia caused by protein C deficit, had a stroke during pregnancy, and preeclampsia in the first gestational semester; therefore, she was subjected to the cesarean section on the 35th week of pregnancy. Stroke episodes during pregnancy can be very aggressive because it can lead to death or disabilities, not only in the mother but also in the fetus. Based on the association between thrombotic processes and complications, prophylactic anticoagulant therapy is recommended for women with thrombophilia who had a stroke and/or certain adverse pregnancy outcomes, such as recurrent miscarriages.