Electroencephalography During Normotensive and Hypertensive Pregnancy: A Systematic Review

Brussé, Ingrid A.; Peters, N.; Steegers, Eric A.P.; Duvekot, Johannes J.; Visser, Gerhard H.

doi:10.1097/ogx.0b013e31821286f1

Cited by 12 publications

(10 citation statements)

References 39 publications

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“…The electroencephalogram (EEG) is sensitive enough to distinguish if an intra-partum seizure has resulted from eclampsia or if the mother suffered an epileptic seizure during labor (244, 245). Furthermore, hypertensive PE and eclamptic women exhibit changes in EEG recordings compared to normotensive pregnant and non-pregnant females (244).…”

Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

“…Furthermore, hypertensive PE and eclamptic women exhibit changes in EEG recordings compared to normotensive pregnant and non-pregnant females (244). PE and eclamptic women demonstrate both diffuse and focal slowing of delta and theta waves, typically localized to the occipital lobe (234, 244–247). Eclamptic women exhibit a significantly greater number of spike discharges than PE patients (234, 244–247).…”

Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

“…PE and eclamptic women demonstrate both diffuse and focal slowing of delta and theta waves, typically localized to the occipital lobe (234, 244–247). Eclamptic women exhibit a significantly greater number of spike discharges than PE patients (234, 244–247). Collectively, these anatomical, hemodynamic, histopathological, and electrophysiological changes that result from PE are manifested in cognitive and behavioral impairments.…”

Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

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Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia

2016

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Preeclampsia (PE) is a form of gestational hypertension that complicates ~ 5 percent of pregnancies worldwide. Over 70 percent of the fatal cases of PE are attributed to cerebral edema, intracranial hemorrhage, and eclampsia. The etiology of PE originates from abnormal remodeling of the maternal spiral arteries, creating an ischemic placenta that releases factors that drive the pathophysiology. An initial neurological outcome of PE is the absence of the autonomically regulated cardiovascular adaptations to pregnancy. PE patients exhibit sympathetic overactivation, in comparison to both normotensive pregnant and hypertensive non-pregnant females. Moreover, PE diminishes baroreceptor reflex sensitivity (BRS) beyond that observed in healthy pregnancy. The absence of the cardiovascular adaptations to pregnancy, combined with sympathovagal imbalance and a blunted BRS leads to life-threatening neurological outcomes. Behaviorally, the increased incidences of maternal depression, anxiety, and post-traumatic stress disorder (PTSD) in PE are correlated to low fetal birth weight, intrauterine growth restriction (IUGR) and premature birth. This review addresses these neurological consequences of PE that present in the gravid female both during and after the index pregnancy.

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Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

Section: Cerebrovascular and Higher Function Neurological Consequencementioning

confidence: 99%

See 1 more Smart Citation

Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia

2016

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“…He attributed the cortical lesion to failure of cerebral autoregulation resulting in rupture of capillary junctions with leakage of both plasma and red blood cells. On the other hand, Brusse IA et al 6 and Sibai et al 4 did not find any correlation between EEG changes and the degree of blood pressure elevation. 4,7 Sibai et al reported EEG diffuse slowing followed by focal slowing and intermittent diffuse/focal spike activity in review of previous studies (n=84).…”

Section: Discussionmentioning

confidence: 92%

“…Abnormal CT scan was seen in 14 (58.33%) patients, in which most common findings was leukoencephalopathy in 8 (33.33%) patients followed by arterial infarct in 3 (12.5%) patients, whereas venous infarct and intracranial haemorrhage were noted in one patient each. Various CT scan abnormalities 8,6,12 in eclamptic patients include patchy and diffuse cerebral oedema, loss of cortical sulci and decreased ventricular size, hydrocephalus, intraventricular and parenchymal haemorrhages and infarcts involving the cortex and basal ganglia. 13,14 MRI appears to be more sensitive than CT scan in detecting changes related to eclampsia.…”

Section: Discussionmentioning

confidence: 99%

Neurological Complications of Eclampsia

Khan¹,

Singh²,

Singh³

2016

jemds

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BACKGROUNDEclampsia account for a third of maternal mortality in developing country. Eclampsia is a dreadful complication of hypertensive disorder of pregnancy and with high mortality and morbidity. The neurological manifestation of eclampsia consist of seizure and altered sensorium or coma on a background of pre-eclampsia. The major cause of mortality and morbidity includes encephalopathy, CVA and pulmonary oedema. Present study planned for evaluation of the neurological complications in patients of eclampsia. MATERIALS AND METHODSTwenty seven cases of complicated eclampsia who were admitted in Department of Gynae and Obst and Department of Medicine, BRD Medical College, Gorakhpur, were enrolled for the study. We selected all definite cases of eclampsia who did not recover neurologically within 48 hours of cessation of seizures. Detailed clinical examination was supported by investigations to assess renal, hepatic and haematological parameters along with electrophysiological and neuroimaging. Perinatal and maternal mortality was also recorded. RESULTSThe age of patients ranges from to 18 to 38 years. Convulsions commonly last for 21-30 hrs. (13 patients, 48.14%) followed by 11-20 hrs. (5 patients, 18.51%) and in only 2 patients (7.4%) convulsions last for > 30 hrs. Status epileptics was noted in 12/27 (44.44%) patients. Visual aura was noted in only 5/27 (18.51%) patients. Foetal mortality was 33.33% (9/27) and maternal mortality was 18.51% (5/27).EEG was abnormal in 15 (54.53%) patients. The most common finding was diffuse slowing, which was noted in 8 (29.62%) patients followed by hemispheric slowing and non-specific slowing.CT/MRI was done in 24/27 patients. Abnormal CT was seen in 14 (58.33%) patients. Out of them most common finding was leukoencephalopathy which was found in (8 patients, 33.33%) followed by arterial infarct (13, 12.5% patients), venous infarct in 4.16% patients and intracranial bleed in 4.16% patients. CONCLUSIONA wide range of Neurological complications were found in the cases of eclampsia. These include status epilepticus, focal neurological deficits, cranial nerve involvement and vision loss along with convulsions leading to significant morbidity. In EEG, most common finding was diffuse slowing. Leukoencephalopathy and arterial infarcts were the most common findings in CT scan. MRI appears to be more sensitive than CT scan in detecting changes related to eclampsia. The lesions are hyperintense on T2 weighted images.

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Elevated levels of protein AMBP in cerebrospinal fluid of women with preeclampsia compared to normotensive pregnant women

Berg

Duvekot

Güzel³

et al. 2016

Prot. Clin. Appl.

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The current study showed a clear difference between the protein profiles of CSF from patients with PE and normotensive pregnant women. Protein AMBP is a precursor of a heme-binding protein that counteracts the damaging effects of free hemoglobin, which may be related to the presence of free hemoglobin in CSF. Protein levels showed correlations with clinical symptoms during pregnancy and postpartum. To our knowledge, this is the first LC-MS/MS proteome profiling study on a unique set of CSF samples from (severe) preeclamptic patients and normotensive pregnant women.

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Electroencephalography During Normotensive and Hypertensive Pregnancy: A Systematic Review

Cited by 12 publications

References 39 publications

Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia

Preeclampsia and the brain: neural control of cardiovascular changes during pregnancy and neurological outcomes of preeclampsia

Neurological Complications of Eclampsia

Elevated levels of protein AMBP in cerebrospinal fluid of women with preeclampsia compared to normotensive pregnant women

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