SPONTANEOUS INTRACEREBRAL HEMORRHAGE IN A COVID 19 POSTPARTUM WITH PREECLAMPSIA: A CASE REPORT

Problem Statement: Coronavirus disease 2019 (COVID 19) is a disease caused by severe acute respiratory syndrome coronavirus that has been associated with severe multiorgan complications. Unexpected development of this global health crisis makes health care practitioners unaware of the pathogenesis of this new disease.

Methods: Strategies in management are constantly changing thus reports and case series are crucial in expanding our understanding of COVID 19 in pregnancy. At this juncture, there is less reported case of a spontaneous intracerebral hemorrhage in a COVID 19 postpartum and also limited reported cases of stroke in patients with postpartum preeclampsia. Presented in this paper is a case of COVID 19 patient diagnosed with postpartum preeclampsia which progressed to a spontaneous intracerebral hemorrhage.

Results: Treatment of spontaneous intracerebral hemorrhage in pregnancy is multidisciplinary. The patient underwent left frontoparietotemporal decompressive hemicraniectomy and evacuation of hematoma, treated with low molecular weight heparin, antihypertensives and anticonvulsants.

Conclusion: Stroke rarely happens during pregnancy but once it occurs it is associated with preeclampsia. Acute Cerebrovascular disease is a significant manifestation of COVID 19 with incidence rate of 1-6% in patients which equates a large proportion of the COVID 19 population as SARS-CoV-2 affects millions of people worldwide which can be caused by direct endothelial inflammation, systemic inflammation and hypercoagulopathy. There should be a higher index of suspicion of stroke for COVID 19 patients presenting with neurological symptoms even in low risk patients. We must be critical in postpartum care of COVID 19 patients including coagulation studies, and administration of thromboprophylaxis