Back to Search
Start Over
Pregnancy in CADASIL
- Source :
- Acta Neurologica Scandinavica. 136:668-671
- Publication Year :
- 2017
- Publisher :
- Hindawi Limited, 2017.
-
Abstract
- Objectives Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited cerebral small vessel disease caused by NOTCH3 gene mutations. CADASIL women are frequently considered at high risk of systemic vascular events during pregnancy and often prescribed with antithrombotic drugs. This decision is not evidence-based considering the lack of data about pregnancy outcome in CADASIL. We describe our experience on pregnancy in CADASIL patients. Materials and methods We reviewed records of 50 CADASIL females followed in our center, and we collected prospective information in six patients for a total of 93 pregnancies. Results No woman had the disease onset or suffered from cerebral vascular ischemic events during pregnancy. Sixteen miscarriages (17.2%) were recorded. There were 72 vaginal births, and five cesarean sections. Considering the six patients followed prospectively (for a total of eight pregnancies), data on fetal growth and newborns weight were in line with those from the general population. Considering gestational complications, we recorded mild proteinuria without hypertension in one patient and hyperinsulinemia and pre-eclampsia in another affected by a known nephropathy. Antithrombotic drugs were used in three patients, in one for an unrelated coexisting prothrombotic condition. Conclusions CADASIL does not seem to be associated with an unfavorable outcome of pregnancy either for women and fetuses. Patients and treating physicians should be reassured that pregnancy can be safely initiated in CADASIL, as there is no evidence to support a specific preventive antithrombotic treatment during pregnancy in CADASIL. Larger studies are needed to definitively confirm these conclusions.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pediatrics
Population
CADASIL
Gene mutation
Miscarriage
Leukoencephalopathy
03 medical and health sciences
0302 clinical medicine
Pregnancy
Antithrombotic
medicine
Birth Weight
Humans
030212 general & internal medicine
education
Antithrombotic treatment
Prognosis
Neurology
Neurology (clinical)
education.field_of_study
business.industry
Infant, Newborn
Pregnancy Outcome
General Medicine
medicine.disease
Surgery
Pregnancy Complications
Gestation
Female
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 00016314
- Volume :
- 136
- Database :
- OpenAIRE
- Journal :
- Acta Neurologica Scandinavica
- Accession number :
- edsair.doi.dedup.....bb06a8a944061b7df38146a1b26f3989