Special problems of childbirth in neurological diseases

1. Big picture

Pregnancy, delivery, and the postpartum period create special problems in neurology because they change:

• seizure threshold;
• drug metabolism;
• coagulation;
• immune activity;
• intracranial pressure risk;
• respiratory reserve;
• autonomic function;
• fatigue and sleep;
• safety of medications for the fetus and breastfeeding infant.

For the final exam, the most important diseases are:

1. Epilepsy
2. Multiple sclerosis
3. Myasthenia gravis
4. Cerebral venous sinus thrombosis
5. Stroke and hemorrhage
6. Headache disorders, especially migraine, eclampsia, and idiopathic intracranial hypertension
7. Neuromuscular disorders affecting breathing and labor
8. Spinal cord injury and severe disability

The safest exam approach:

In pregnant or postpartum neurological patients, protect the mother first, because maternal hypoxia, seizures, coma, and respiratory failure are also dangerous for the fetus.

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