Postpartum intracerebral hematoma following in vitro fertilization

Year 2022, Volume: 39 Issue: 2, 566 - 568, 18.03.2022

Hatice Şeyma Akça , Serdar Özdemir

Abstract

Objective
To contribute to the literature with a case of postpartum intracerebral hemorrhage following in vitro fertilization (IVF) treatment.
Case Report
A 41-year-old female patient presented to our clinic with the complaint of headache lasting for four days. It was determined that the patient underwent a cesarean section 10 days earlier and had received preoperative IVF treatment. Her general condition was moderate. She was cooperative and oriented but apathetic and drowsy. There was 4/5 paralysis in the right lower extremity and right arm. Her blood pressure was 197/115 mmHg. In the brain CT, there was an approximately 6x1.5 cm parenchymal hematoma and subarachnoid hemorrhage in the deep white matter in the left frontal region. The patient was followed up in the intensive care unit for five days, and then admitted to the ward following the improvement in her general condition and apathic findings.
Conclusion
Although there are no risk factors for intracerebral hemorrhage that occurs after IVF, it can present with neurological sequelae during recovery. There is a need for detailed studies and meta-analyses that will guide both the treatment approach to these patients and preventive measures.

Keywords

intracerebral hematoma,, postpartum intracerebral hematoma, IVF

References

• 1) Ascanio, LC., Maragkos, GA., Young, BC., Boone, MD., Kasper, EM., 2019. Spontaneous Intracranial Hemorrhage in Pregnancy: A Systematic Review of the Literature. Neurocrit Care. 30,5-15. Doi:10.1007/s12028-018-0501-4.
• 2) Bose, S., Ali, Z., Rath, GP., Prabhakar, H., 2007. Spontaneous spinal epidural haematoma: a rare cause of quadriplegia in the post-partum period, BJA: British Journal of Anaesthesia. 99(6),855-7. Doi:10.1093/bja/aem265.
• 3) Miller, EC., Yaghi, S., Boehme, AK., Willey, JZ., Elkind, MS., Marshall, RS., 2016. Mechanisms and outcomes of stroke during pregnancy and the postpartum period: A crosssectional study. Neurol Clin Pract. 6(1), 29-39. Doi:10.1212/CPJ.0000000000000214.
• 4) Winarno, AS., Schloesser, L., Dietzel, F., Balan, P., Hoehn, T., Hampl, M., et al., 2019. Intracerebral Hemorrhage of Brainstem in triple pregnancy after in vitro fertilization by receiving Ovum Donation: A case report and review. Clin J Obstet Gynaecol. 2, 138-144. Doi: 10.29328/journal.cjog.1001037.
• 5) Yoshida, K., Takahashi, JC., Takenobu, Y., Suzuki, N., Ogawa, A., Miyamoto, S., 2017. Strokes associated with pregnancy and puerperium: a nationwide study by the japan stroke society. Stroke. 48(2), 276–82. Doi: 10.1161/STROKEAHA.116.014406.
• 6) Yoshimatsu, J., Ikeda, T., Katsuragi, S., Minematsu, K., Toyoda, K., Nagatsuka, K., et al., 2014. Factors contributing to mortality and morbidity in pregnancy-associated intracerebral hemorrhage in Japan. J Obstet Gynaecol Res. 40(5), 1267- 73. Doi: 10.1111/jog.12336.
• 7) Takahashi, JC., Iihara, K., Ishii, A., Watanabe, E., Ikeda, T., Miyamoto, S., 2014. Pregnancyassociated intracranial hemorrhage: results of a survey of neurosurgical institutes across Japan. J Stroke Cerebrovasc Dis. 23(2), e65–71. Doi: 10.1016/j.jstrokecerebrovasdis.2013.08.017.
• 8) Toossi, S., Moheet, AM., 2019. Intracerebral Hemorrhage in Women: A Review with Special Attention to Pregnancy and the Post-Partum Period. Neurocrit Care. 31, 390-8. Doi:10.1007/s12028-018-0571-3.
• 9) Trounson, A., Mohr, L., 1983. Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Nature. 305, 707-9.