Hemorragia Intracerebral durante el Embarazo y Puerperio un desafío Obstétrico y Neurológico en el Ecuador

Autores/as

DOI:

https://doi.org/10.70577/asce.v4i4.563

Palabras clave:

Hemorragia intracerebral; Embarazo; Hipertensión; Preeclampsia; Eclampsia

Resumen

 

La hemorragia intracerebral durante el periodo de gestación tiene una incidencia de alrededor de 30 casos por cada 100 000 embarazos, catalogándose una emergencia médica catastrófica con alta mortalidad materna infantil. En el Ecuador donde los trastornos hipertensivos del embarazo contribuyen una de las primeras causas de muerte maternas, fetal, por lo tanto, su identificación y manejo multidisciplinario son vitales, en este artículo se revisará la epidemiología, etiología, diagnóstico y manejo terapéutico.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Algarín-Lara, E. L., García-Perlaza, J. A., Patiño-Patiño, J. F., Maldonado-Ramírez, L. F., Aldana-Roa, E., & Osorio-Rodríguez, E. L. (2022). Hemorragia intracerebral espontánea posterior a preeclampsia severa durante el puerperio mediato: A propósito de un caso. Ginecología y Obstetricia de México, 90(2), 196–201. https://doi.org/10.24245/gom.v90i2.5773 DOI: https://doi.org/10.24245/gom.v90i2.5773

Algahtani, H., Bazaid, A., Shirah, B., & Bouges, R. N. (2022). Cerebral venous sinus thrombosis in pregnancy and puerperium: A comprehensive review. Brain Circulation, 8(4), 180–187. https://doi.org/10.4103/bc.bc_50_22 DOI: https://doi.org/10.4103/bc.bc_50_22

American College of Obstetricians and Gynecologists. (2020). Gestational hypertension and preeclampsia (Practice Bulletin No. 222). Obstetrics & Gynecology, 135(6), e237–e260. https://doi.org/10.1097/AOG.0000000000003891 DOI: https://doi.org/10.1097/AOG.0000000000003891

Barbarite, E., Hussain, M. S., Dellarole, A., Elhammady, M. S., & Peterson, E. C. (2016). The management of intracranial aneurysms during pregnancy: A systematic review. Neurosurgery, 79(1), 79–88. https://doi.org/10.1227/NEU.0000000000001111 DOI: https://doi.org/10.5137/1019-5149.JTN.15773-15.0

Beckett, A. G., McFadden, M. J., & Warrington, J. P. (2023). Preeclampsia history and postpartum risk of cerebrovascular disease and cognitive impairment: Potential mechanisms. Frontiers in Physiology, 14, 1141002. https://doi.org/10.3389/fphys.2023.1141002 DOI: https://doi.org/10.3389/fphys.2023.1141002

Brohan, M. P., Daly, F. P., Kelly, L., McCarthy, F. P., Khashan, A. S., Kublickiene, K., & Barrett, P. M. (2023). Hypertensive disorders of pregnancy and long-term risk of maternal stroke—A systematic review and meta-analysis. American Journal of Obstetrics & Gynecology, 229(3), 248–268. https://doi.org/10.1016/j.ajog.2023.03.034 DOI: https://doi.org/10.1016/j.ajog.2023.03.034

Cogollo G., M., Julio N., L. C., & Alvarado C., D. E. (2016). Hemorragia intracraneal asociada a preeclampsia severa. Revista Chilena de Obstetricia y Ginecología, 81(6), 511–514. https://doi.org/10.4067/S0717-75262016000600010 DOI: https://doi.org/10.4067/S0717-75262016000600010

Cook, A. M., et al. (2020). Guidelines for the acute treatment of cerebral edema in neurocritical care patients. Neurocritical Care, 32, 647–666. https://doi.org/10.1007/s12028-020-00959-7 DOI: https://doi.org/10.1007/s12028-020-00959-7

Countouris, M., et al. (2025). Hypertension in pregnancy and postpartum: Current standards and opportunities to improve care. Circulation, 151(7), 490–507. https://doi.org/10.1161/CIRCULATIONAHA.124.073302 DOI: https://doi.org/10.1161/CIRCULATIONAHA.124.073302

Dicpinigaitis, A. J., et al. (2021). Endovascular thrombectomy for treatment of acute ischemic stroke during pregnancy and the early postpartum period. Stroke, 52(12), 3796–3804. https://doi.org/10.1161/STROKEAHA.121.034303 DOI: https://doi.org/10.1161/STROKEAHA.121.034303

Díaz Cárdenas, V., Rovira Madrid, P. A., Contreras Diart, C. E., Pérez Canchila, L. F., Jaimes Bautista, J. D., Álvarez Castro, M. C., & Hernández Muñoz, D. M. (2023). Riesgos y beneficios de la tomografía computarizada en el embarazo. Ciencia Latina Revista Científica Multidisciplinar, 7(5), 5045–5057. https://doi.org/10.37811/cl_rcm.v7i5.8105 DOI: https://doi.org/10.37811/cl_rcm.v7i5.8105

Easterling, T., et al. (2019). Treatment of hypertension in pregnancy. The Lancet, 394(10204), 1011–1021. https://doi.org/10.1016/S0140-6736(19)31282-6 DOI: https://doi.org/10.1016/S0140-6736(19)31282-6

Gómez, E. B., Bastidas-Vivas, R. E., Giacchino, A., Manin, A., & Baston, C. (2024). Características y hallazgos imagenológicos de la cefalea en el embarazo y el puerperio. Revista Argentina de Radiología, 88(4), 159–167. https://doi.org/10.24875/RAR.22000023 DOI: https://doi.org/10.24875/RAR.22000023

Greenberg, S. M., et al. (2022). 2022 Guideline for the management of patients with spontaneous intracerebral hemorrhage. Stroke, 53(7), e282–e361. https://doi.org/10.1161/STR.0000000000000407 DOI: https://doi.org/10.1161/STR.0000000000000407

Hung, L. C., et al. (2022). Impact of hypertensive disorders of pregnancy on the risk of stroke stratified by subtypes and follow-up time. Stroke. https://doi.org/10.1161/STROKEAHA.121.034109 DOI: https://doi.org/10.1161/STROKEAHA.121.034109

Kashkoush, A. I., et al. (2017). Cerebral venous sinus thrombosis in pregnancy and puerperium: A pooled, systematic review. Journal of Clinical Neuroscience, 39, 9–15. https://doi.org/10.1016/j.jocn.2017.02.046 DOI: https://doi.org/10.1016/j.jocn.2017.02.046

Kassebaum, N. J., et al. (2016). Global, regional, and national levels of maternal mortality, 1990–2015: A systematic analysis. The Lancet, 388(10053), 1775–1812. https://doi.org/10.1016/S0140-6736(16)31470-2 DOI: https://doi.org/10.1016/S0140-6736(16)31470-2

Mazur, N. K., Fercho, J. M., Kałas, M., Szaruta-Raflesz, K., Grzybowska, M. E., Siemiński, M., & Wydra, D. G. (2025). Intracranial hemorrhage during pregnancy: An interdisciplinary literature review and a rare case report. Journal of Clinical Medicine, 14(4), 1361. https://doi.org/10.3390/jcm14041361 DOI: https://doi.org/10.3390/jcm14041361

Meeks, J. R., et al. (2020). Association of primary intracerebral hemorrhage with pregnancy and the postpartum period. JAMA Network Open, 3(4), e202769. https://doi.org/10.1001/jamanetworkopen.2020.2769 DOI: https://doi.org/10.1001/jamanetworkopen.2020.2769

Mercado-González, A. F., Moya-Pacheco, W. T., Fornasini-Salvador, M. V., Peláez-Díaz, G. A., & Baldeón-Tixe, M. E. (2018). Manejo clínico de hemorragia subaracnoidea por aneurisma intracraneal en una mujer embarazada en Quito, Ecuador. Revista Colombiana de Obstetricia y Ginecología, 69(2), 132–139. https://doi.org/10.18597/rcog.3048 DOI: https://doi.org/10.18597/rcog.3048

Miller, E. C., Gatollari, H. J., Too, G., Boehme, A. K., Leffert, L., Elkind, M. S. V., & Willey, J. Z. (2016). Risk of pregnancy-associated stroke across age groups. JAMA Neurology, 73(12), 1461–1469. https://doi.org/10.1001/jamaneurol.2016.3774 DOI: https://doi.org/10.1001/jamaneurol.2016.3774

Mohamed, M. B., et al. (2025). Hemorrhagic stroke secondary to eclampsia: A case report. International Medical Case Reports Journal, 18, 775–782. https://doi.org/10.2147/IMCRJ.S516956 DOI: https://doi.org/10.2147/IMCRJ.S516956

Palmiero, P., Caretto, P., Ciccone, M. M., & Maiello, M. (2025). Long-term cardiovascular risk and maternal history of pre-eclampsia. Journal of Clinical Medicine, 14(9), 3121. https://doi.org/10.3390/jcm14093121 DOI: https://doi.org/10.3390/jcm14093121

Rana, S., Lemoine, E., Granger, J. P., & Karumanchi, S. A. (2019). Preeclampsia: Pathophysiology, challenges, and perspectives. Circulation Research, 124(7), 1094–1112. https://doi.org/10.1161/CIRCRESAHA.118.313276 DOI: https://doi.org/10.1161/CIRCRESAHA.118.313276

Ray, J. G., Vermeulen, M. J., Bharatha, A., Montanera, W. J., & Park, A. L. (2016). Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA, 316(9), 952–961. https://doi.org/10.1001/jama.2016.12126 DOI: https://doi.org/10.1001/jama.2016.12126

Roberge, S., Bujold, E., & Nicolaides, K. H. (2018). Aspirin for the prevention of preeclampsia and fetal growth restriction: A systematic review and meta-analysis. American Journal of Obstetrics & Gynecology, 218(3), 287–293.e1. https://doi.org/10.1016/j.ajog.2017.11.561 DOI: https://doi.org/10.1016/j.ajog.2017.11.561

Sacco, R. L., et al. (2020). An updated definition of stroke for the 21st century. Journal of the American College of Cardiology, 75(5), 524–531. https://doi.org/10.1016/j.jacc.2019.11.029 DOI: https://doi.org/10.1016/j.jacc.2019.11.029

Sariyeva, M., et al. (2023). Stroke associated with pregnancy: A systematic review. Neurology, 101(1), e1–e15. https://doi.org/10.1212/WNL.0000000000202955 DOI: https://doi.org/10.1212/WNL.0000000000202955

Sariyeva, M., Haghighi, N., Mitchell, A., Booker, W. A., Petersen, N. H., Shields, A. D., et al. (2024). Primary and secondary intracerebral hemorrhage in pregnant and nonpregnant young adults. Journal of the American Heart Association, 13(7), e034032. https://doi.org/10.1161/JAHA.123.034032 DOI: https://doi.org/10.1161/JAHA.123.034032

Silvis, S. M., et al. (2019). Postpartum period is a risk factor for cerebral venous thrombosis: A case-control study. Stroke, 50(2), 501–503. https://doi.org/10.1161/STROKEAHA.118.023017 DOI: https://doi.org/10.1161/STROKEAHA.118.023017

Verho, L., et al. (2023). Pregnancy-associated stroke and the recurrence of stroke and other complications in subsequent pregnancies: Population-based retrospective cohort study. BJOG, 130(11), 1421–1429. https://doi.org/10.1111/1471-0528.17503 DOI: https://doi.org/10.1111/1471-0528.17503

Descargas

Publicado

2025-12-18

Cómo citar

Torres Yaguana, J. Y., Castillo Cajo, G. C., Martillo Soffe, N. S., Paladines Delgado, M. D., & Guillén Friman, H. F. (2025). Hemorragia Intracerebral durante el Embarazo y Puerperio un desafío Obstétrico y Neurológico en el Ecuador. ASCE MAGAZINE, 4(4), 3102–3115. https://doi.org/10.70577/asce.v4i4.563

Artículos similares

También puede Iniciar una búsqueda de similitud avanzada para este artículo.