Cerebral Angiographic Characteristics, Clinical Profiles, and Long-Term Outcomes of Obstetric Patients with Spontaneous Intracerebral Hemorrhage: Insights from a Philippine Tertiary Government Hospital

This study describes the clinical profiles, causes, and long-term outcomes of spontaneous intracerebral hemorrhage (ICH) in pregnant women at Vicente Sotto Memorial Medical Center (VSMMC). The investigation aimed to identify risk factors associated with ICH, evaluate maternal and fetal outcomes, and examine correlations between clinical characteristics and patient outcomes. A retrospective descriptive design was employed, reviewing the charts of obstetric patients with confirmed intraparenchymal hemorrhage from January 2015 to December 2023. Data collection focused on demographics, clinical history, and outcomes, with statistical analyses performed to determine significant patterns. The study analyzed 60 cases, revealing that 48% of patients improved or recovered while 52% experienced mortality. Most cases involved women aged 26-40 years, with intraparenchymal hemorrhage (93%) being the most prevalent type. The third trimester presented higher mortality rates (40%), particularly among patients with eclampsia (57%). Emergency cesarean sections (65%) and medical management (57%) were common interventions. Pregnancy-related hypertension emerged as a significant factor impacting maternal outcomes. Fetal outcomes included 47% term deliveries and 10% fetal or neonatal deaths, highlighting the severe implications of ICH during pregnancy. The findings underscore the association of eclampsia, third-trimester presentation, and emergent cesarean sections with higher maternal mortality. Effective management during the third trimester is crucial, particularly for patients with comorbidities such as eclampsia. The nearly equal distribution of maternal recovery and mortality highlights the unpredictable course of ICH in obstetric patients. Diverse fetal outcomes, ranging from term and preterm deliveries to fetal or neonatal deaths, emphasize the dual challenges ICH poses to maternal and fetal health.