Thrombosis risk during pregnancy after history of cerebral venous thrombosis

Introduction. - Few data have been published about the prognosis of a pregnancy following an episode of venous cerebral thrombosis (CVT), and far less about preventive strategy. Methods. - This is a retrospective study of a case series of 11 pregnancies in six women who had previously presented a CVT. Results. - The first pregnancies after CVT occurred on average 58 months later. Prevention with aspirin or heparin was administered in ten cases during pregnancy, and in all the cases with heparin in postpartum. No recurrence of CVT was observed. A minor pulmonary embolism was diagnosed in postpartum in one case. Conclusion. - Prognosis of a pregnancy after a CVT seems to be favourable if a sufficient delay after CVT is respected. Although no results of controlled trials are available, prophylaxis with heparin is probably reasonable as benefit seems higher than risks and is strongly advised during the postpartum period. (C) 2014 Published by Elsevier Masson SAS on behalf of the Societe nationale francaise de medecine interne (SNFMI).