pregnancy chorea
Introduction
Introduction to pregnancy and dance disease Pregnancy chorea (choreagravidarum) is a rare pregnancy complication. It is currently considered to be a late-onset chorea caused by pregnancy. The cause of this disease is unclear. Pregnancy is only an inducement. Pregnancy-induced hypertension syndrome can cause this disease. A history of infection or heart disease, the dance-like action stops immediately after termination of pregnancy. A few authors believe that pregnancy chorea can be induced by mental factors, systemic toxemia or infections (such as mild encephalitis). basic knowledge The proportion of illness: 0.005% Susceptible people: more common in primiparas aged 17 to 23 Mode of infection: non-infectious Complications: abortion
Cause
The cause of pregnancy chorea
(1) Causes of the disease
The true cause of pregnancy chorea is unclear. Pregnancy may be just a predisposing factor, not the underlying cause of chorea.
(two) pathogenesis
Some patients have a history of rheumatic fever or scarlet fever in the past. About 40% of patients have a history of small dance disease at an early age, and the frequency of rheumatism is similar to that of small chorea. Therefore, more people think that this disease It is related to rheumatism.
Another person found at the autopsy that the patient's brain was almost full of congestion and bleeding. Others found that the brain, liver, kidney and spleen have degeneration and inflammatory changes, but there is no evidence of endocarditis, so there are reports that the disease It is caused by mild encephalitis caused by pregnancy-induced hypertension syndrome or infectious disease. The reason for pregnancy-induced hypertension syndrome is that the patient has no history of infection or heart disease. After termination of pregnancy, the dance-like action stops immediately.
A few authors believe that pregnancy and dance disease can be induced by mental factors, systemic toxemia or infection, and there are also people in Europe who believe that pregnancy and chorea are due to abnormalities in the fetus.
Prevention
Pregnancy chorea prevention
Pay attention to the perinatal period of pregnant women, especially perinatal care. Those with a history of rheumatic fever should pay special attention to prevent rheumatism recurrence, infection and pregnancy-induced hypertension syndrome, and terminate pregnancy if necessary.
Complication
Complications of pregnancy chorea Complications
The fetal mortality rate is 2 times higher than normal, and patients often have miscarriage.
Symptom
Symptoms of pregnancy and chorea common symptoms abortion dance-like gait, lack of concentration, irritability, systemic failure
The disease is most common in primiparas aged 17 to 23 years old. It may recur in another pregnancy. It is extremely rare for women who are first born in the 30s and older.
The clinical symptoms of this disease are similar to those of the heavier small chorea. When the dance-like movement occurs several weeks before, there are often headaches and personality changes. The symptoms of systemic failure may appear earlier than the small chorea. It is reported in the literature that the disease is dead. The rate is 13.1%, and the mortality rate of the fetus is about 2 times higher. However, the majority of babies born in full-term are normal. Only a few reported infants are malformed. Patients often have miscarriage. The chorea can be during pregnancy or after delivery. It stopped on its own within 1 month, and it was also reported to be stopped immediately after abortion.
Examine
Examination of pregnancy chorea
1. Blood, urine, erythrocyte sedimentation rate, C-reactive protein and anti-streptolysin "O" titer examination, with differential diagnosis.
2. There are very few abnormalities in cerebrospinal fluid examination.
3. EEG examination may have minor abnormalities, but this abnormal change is not specific.
4. CT, MRI examination has a differential diagnosis significance.
Diagnosis
Diagnosis and diagnosis of pregnancy chorea
diagnosis
According to the history of pregnancy, the typical clinical manifestations, symptoms and small chorea are similar. There are often headaches and personality changes in the first few weeks of dance-like movements. The diagnosis is not difficult.
Differential diagnosis
Must pay attention to the identification of other causes of chorea and similar symptoms:
1. Rheumatic chorea is a common manifestation of rheumatic fever in the nervous system, and is more common in children and adolescents.
2. Huntington's disease is more common in middle age, often with genetic history and dementia.
