Neuroimaging in pregnancy: a review of clinical indications and obstetric outcomes

Abstract

Objective: To determine indications and outcomes of pregnant women requiring neurologic imaging at a tertiary care center.

Methods: We reviewed medical records of women receiving magnetic resonance (MR) head imaging during pregnancy to determine indications for such imaging and their pregnancy outcomes.

Results: Between April 2007 and December 2008, 60 pregnant women presented to Brigham and Women's Hospital with severe headache or other acute neurologic complaint and underwent head imaging. Two patients were found to have significant findings considered to be neurologic emergencies: a right thalamic hemorrhage and a subarachnoid hemorrhage. Nine patients had abnormal findings not requiring immediate intervention but deeming further evaluation. Sixteen patients had abnormal findings determined to be incidental and unrelated to their indication for imaging. Thirty-three patients had unremarkable imaging studies. The most common presenting symptoms included headache (70%) and visual disturbances (48%). The most common imaging studies obtained were MR brain without contrast (87%) and MR angiography head without contrast (73%). The majority of patients (96%) delivered in the third trimester without significant complications.

Conclusions: Most women who receive head imaging in pregnancy do not have adverse findings and have good obstetrical outcomes.

• Headache
• magnetic resonance
• neurologic emergencies
• neurologic symptoms
• obstetric outcomes