{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:08:03Z","timestamp":1764806883966,"version":"3.46.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a rare case of peripartum pontine stroke in a 34-year-old primipara\n                    initially attributed to an episode of severe transient hypotension caused by the\n                    subdural spread of local anesthetic during epidural analgesia for delivery. The\n                    rapid intrapartum intervention by the obstetric team because of spinal shock\n                    clinical pictures and fetal bradycardia using high vacuum extraction prevented\n                    the risk of fetal ischemic-hypoxic damage. A healthy child was born with an\n                    Apgar score of 8\/10, 3790 grams \/53 cm, with a normal neonatal course. On the\n                    third postpartum day, because of persistent neurologic symptoms (headache,\n                    urinary, and fecal incontinence), brain magnetic resonance imaging indicated a\n                    pontine ischemic lesion. The symptoms gradually regressed with acetylsalicylic\n                    acid and physical therapy, and on the 17th day, the patient was discharged home.\n                    After puerperium and recovery, thrombophilia were detected. The case indicates\n                    the importance of rapid intervention by the obstetric team in case of sudden\n                    peripartum maternal and fetal complications.<\/jats:p>","DOI":"10.1055\/a-2683-6349","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T23:11:37Z","timestamp":1756768297000},"page":"446-449","source":"Crossref","is-referenced-by-count":0,"title":["Acute peripartum pontine ischemic stroke during epidural\n                    analgesia"],"prefix":"10.1055","volume":"229","author":[{"given":"Ivan","family":"\u0160klebar","sequence":"additional","affiliation":[{"name":"University Department of Anesthesiology, Reanimatology and Intensive\n                    Care Medicine, and Pain Treatment, University Hospital Center Zagreb, Zagreb,\n                    Croatia"},{"name":"School of Medicine, Catholic University of Croatia,\n                    Zagreb, Croatia"},{"name":"Bjelovar University of Applied Sciences, Bjelovar,\n                    Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"Goranovi\u0107","sequence":"additional","affiliation":[{"name":"University Department of Anesthesiology, Resuscitation and Intensive\n                    Care, Sveti Duh University Hospital, Zagreb, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek,\n                    Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasna","family":"\u010cerkez Habek","sequence":"additional","affiliation":[{"name":"University Department of Internal medicine, Unit for Cardiovascular\n                    medicine, Unit for Cardiovascular medicine, Sveti Duh University Hospital,\n                    Zagreb, Croatia"},{"name":"School of Medicine, Catholic University of Croatia,\n                    Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7675-7064","authenticated-orcid":false,"given":"Dubravko","family":"Habek","sequence":"additional","affiliation":[{"name":"University Department of Obstetrics and Gynecology,\n                    Merkur University Hospital, Zagreb, Croatia"},{"name":"School of Medicine, Catholic University of Croatia,\n                    Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/01.AOG.0000172428.78411.b0","article-title":"Incidence and risk factors for stroke in pregnancy and the puerperium","volume":"106","author":"A H James","year":"2005","journal-title":"Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e00097","DOI":"10.1016\/j.crwh.2019.e00097","article-title":"Cerebral pontine infarctions during pregnancy \u2013 A case report and review of the\n                    literature","volume":"21","author":"J K Wildman","year":"2019","journal-title":"Case Rep Womens Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"j4452","DOI":"10.1136\/bmj.j4452","article-title":"Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic\n                    review and Bayesian meta-analysis","volume":"359","author":"F N Croles","year":"2017","journal-title":"BMJ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1111\/j.1365-2044.1985.tb10558.x","article-title":"Extradural block. Confirmation of the injection site by X-ray monitoring","volume":"40","author":"M Mehta","year":"1985","journal-title":"Anaesthesia"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ijoa.2004.07.009","article-title":"Some immediate serious complications of obstetric epidural analgesia and\n                    anaesthesia: a prospective study of 145,550 epidurals","volume":"14","author":"J G Jenkins","year":"2005","journal-title":"Int J Obstet Anesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1177\/0310057X1003800105","article-title":"Subdural block and the anaesthetist","volume":"38","author":"D Agarwal","year":"2010","journal-title":"Anaesth Intens Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1111\/j.1365-2044.1984.tb07277.x","article-title":"Extensive spread of local anaesthetic solution following subdural insertion of\n                    an epidural catheter during labour","volume":"39","author":"G B Smith","year":"1984","journal-title":"Anaesthesia"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1007\/s00415-002-0879-x","article-title":"Clinical spectrum of pontine infarction. Clinical-MRI correlations","volume":"249","author":"E Kumral","year":"2002","journal-title":"J Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s10654-013-9825-8","article-title":"Risk of venous thromboembolism associated with single and combined effects of\n                    Factor V Leiden, Prothrombin 20210A and Methylenetetrahydrofolate reductase\n                    C677T: a meta-analysis involving over 11,000 cases and 21,000 controls","volume":"28","author":"B Simone","year":"2013","journal-title":"Eur J Epidemiol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1056\/NEJM200002103420602","article-title":"Prothrombin and factor V mutations in women with a history of thrombosis during\n                    pregnancy and the puerperium","volume":"342","author":"A Gerhardt","year":"2000","journal-title":"N Engl J Med"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2683-6349.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:04:41Z","timestamp":1764806681000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2683-6349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":10,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2025,12,3]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2683-6349","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"type":"print","value":"0948-2393"},{"type":"electronic","value":"1439-1651"}],"subject":[],"published":{"date-parts":[[2025,9,1]]}}}