Risk factors of brain stroke, specific for female individuals

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Brain stroke is a leading cause of death and disability in female patients. Most cases of stroke are associated with major vascular risk factors (RF), but some factors are specific particularly for females. A personalized approach to assessing risk factors for ischemic stroke (IS) in females contributes to more effective prevention of it. Throughout their lives, in addition to the main risk factors, female individuals are exposed to the influence of additional gender-specific factors, the need for assessment of which is beyond any doubt. Natural hormonal status, exogenous hormonal therapy, pregnancy and related complications change the risk of IS developing, having both a protective and a negative influence at female organism. Awareness of clinicians about risk factors typical for females of each age group is of greatest importance in the primary and secondary prevention of IS.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Marina Maksimova

Scientific Center of Neurology, Moscow

Хат алмасуға жауапты Автор.
Email: ncnmaximova@mail.ru
ORCID iD: 0000-0002-7682-6672
SPIN-код: 5389-7907
Scopus Author ID: 7003900736
ResearcherId: C-7408-2012

MD, Dr. Sci. (Medicine), professor, head of the 2nd Department of neurology

Ресей, 125367, Moscow, 80 Volokolamskoe Highway

Alexandra Ayrapetova

Scientific Center of Neurology, Moscow

Email: aairapetova@yandex.ru
ORCID iD: 0000-0002-9397-3746

MD, PhD (Medicine), junior researcher at the 2nd Department of neurology

Ресей, 125367, Moscow, 80 Volokolamskoe Highway

Әдебиет тізімі

  1. Virani S.S., Alonso A., Aparicio H.J. et al. Heart disease and stroke statistics-2021 update: A report from the American Heart Association. Circulation. 2021; 143(8): e254–e743. https://doi.org/10.1161/cir.0000000000000950. PMID: 33501848.
  2. Максимова М.Ю., Айрапетова А.С. Влияет ли пол на клинические характеристики ишемического инсульта у пациентов в возрасте 45–74 лет? Анналы клинической и экспериментальной неврологии. 2021; 15(1): 32–42. [Maksimova M.Yu., Ayrapetova A.S. Does gender influence the clinical characteristics of ischaemic stroke in patients aged 45–74 years? Annaly klinicheskoy i eksperimental’noy nevrologii = Annals of Clinical and Experimental Neurology. 2021; 15(1): 21–42 (In Russ.)]. https://doi.org/10.25692/acen.2021.1.4. EDN: HEOQXU.
  3. Максимова М.Ю., Айрапетова А.С. Гендерные особенности отдельных факторов риска развития нарушений мозгового кровообращения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2019; 119(12–2): 58–64. [Maksimova M.Yu., Ayrapetova A.S. Gender differences in stroke risk factors. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2019; 119(12–2): 58–64 (In Russ.)]. https://doi.org/10.17116/jnevro201911912258. EDN: KYYOZN.
  4. Rexrode K.M., Madsen T.E., Yu A.Y.X. et al. The impact of sex and gender on stroke. Circ Res. 2022; 130(4): 512–28. https://doi.org/10.1161/circresaha.121.319915. PMID: 35175851. PMCID: PMC8890686.
  5. Holmegard H.N., Nordestgaard B.G., Jensen G.B. et al. Sex hormones and ischemic stroke: A prospective cohort study and meta-analyses. Clin Endocrinol Metab. 2016; 101(1): 69–78. https://doi.org/10.1210/jc.2015-2687. PMID: 26509870.
  6. Scarabin-Carré V., Canonico M., Brailly-Tabard S. et al. High level of plasma estradiol as a new predictor of ischemic arterial disease in older postmenopausal women: The three-city cohort study. J Am Heart Assoc. 2012; 1(3): e001388. https://doi.org/10.1161/jaha.112.001388. PMID: 23130139. PMCID: PMC3487322.
  7. Lee J.S., Yaffe K., Lui L.Y. et al. Prospective study of endogenous circulating estradiol and risk of stroke in older women. Arch Neurol. 2010; 67(2): 195–201. https://doi.org/10.1001/archneurol.2009.322. PMID: 20142527. PMCID: PMC4406483.
  8. Jimenez M.C., Sun Q., Schürks M. et al. Low dehydroepiandrosterone sulfate is associated with increased risk of ischemic stroke among women. Stroke. 2013; 44(7): 1784–89. https://doi.org/10.1161/strokeaha.111.000485. PMID: 23704104. PMCID: PMC3811081.
  9. Pappa T., Vemmos K., Saltiki K. et al. Severity and outcome of acute stroke in women: Relation to adrenal sex steroid levels. Metabolism. 2012; 61(1): 84–91. https://doi.org/10.1016/j.metabol.2011.06.003. PMID: 21820139.
  10. Jacobsen B.K., Oda K., Knutsen S.F., Fraser G.E. Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: The Adventist Health Study, 1976–88. Int J Epidemiol. 2009; 38(1): 245–52. https://doi.org/10.1093/ije/dyn251. PMID: 19188208. PMCID: PMC2722816.
  11. Canoy D., Beral V., Balkwill A. et al. Age at menarche and risks of coronary heart and other vascular diseases in a large UK cohort. Circulation. 2015; 131(3): 237–44. https://doi.org/10.1161/circulationaha.114.010070. PMID: 25512444.
  12. Zhai L., Liu J., Zhao J. et al. Association of obesity with onset of puberty and sex hormones in Chinese girls: A 4-year longitudinal study. PLoS One. 2015; 10(8): e0134656. https://doi.org/10.1371/journal.pone.0134656. PMID: 26247479. PMCID: PMC4527677.
  13. He C., Zhang C., Hunter D.J. et al. Age at menarche and risk of type 2 diabetes: Results from 2 large prospective cohort studies. Am J Epidemiol. 2010; 171(3): 334–44. https://doi.org/10.1093/aje/kwp372. PMID: 20026580. PMCID: PMC2842205.
  14. Elks C.E., Ong K.K., Scott R.A. et al. Age at menarche and type 2 diabetes risk: The EPIC-InterAct study. Diabetes Care. 2013; 36(11): 3526–34. https://doi.org/10.2337/dc13-0446. PMID: 24159179. PMCID: PMC3816901.
  15. Atsma F., Bartelink M.L., Grobbee D.E., van der Schouw Y.T. Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: A meta-analysis. Menopause. 2006; 13(2): 265–79. https://doi.org/10.1097/01.gme.0000218683.97338.ea. PMID: 16645540.
  16. Muka T., Oliver-Williams C., Kunutsor S. et al. Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: A systematic review and meta-analysis. JAMA Cardiol. 2016; 1(7): 767–76. https://doi.org/10.1001/jamacardio.2016.2415. PMID: 27627190.
  17. Parker W.H., Broder M.S., Chang E. et al. Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses’ health study. Obstet Gynecol. 2009; 113(5): 1027–37. https://doi.org/10.1097/AOG.0b013e3181a11c64. PMID: 19384117. PMCID: PMC3791619.
  18. Howard B.V., Kuller L., Langer R. et al. Risk of cardiovascular disease by hysterectomy status, with and without oophorectomy: The Women’s Health Initiative Observational Study. Circulation. 2005; 111(12): 1462–70. https://doi.org/10.1161/01.cir.0000159344.21672.FD. PMID: 15781742.
  19. Parker W.H., Feskanich D., Broder M.S. et al. Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses’ health study. Obstet Gynecol. 2013; 121(4): 709–16. https://doi.org/10.1097/AOG.0b013e3182864350. PMID: 23635669. PMCID: PMC4254662.
  20. Vitale C., Fini M., Speziale G., Chierchia S. Gender differences in the cardiovascular effects of sex hormones. Fundam Clin Pharmacol. 2010; 24(6): 675–85. https://doi.org/10.1111/j.1472-8206.2010.00817.x. PMID: 20199585.
  21. Berg G.A., Siseles N., González A.I. et al. Higher values of hepatic lipase activity in postmenopause: Relationship with atherogenic intermediate density and low density lipoproteins. Menopause. 2001; 8(1): 51–57. https://doi.org/10.1097/00042192-200101000-00009. PMID: 11201516.
  22. Matthews K.A., Meilahn E., Kuller L.H. et al. Menopause and risk factors for coronary heart disease. N Engl J Med. 1989; 321(10): 641–46. https://doi.org/10.1056/NEJM198909073211004. PMID: 2488072.
  23. Woodard G.A., Brooks M.M., Barinas-Mitchell E. et al. Lipids, menopause, and early atherosclerosis in Study of Women’s Health Across the Nation Heart women. Menopause. 2011; 18(4): 376–84. https://doi.org/10.1097/gme.0b013e3181f6480e. PMID: 21107300. PMCID: PMC3123389.
  24. Kim S.H., Sim M.Y., Park S.B. Association between duration of reproductive lifespan and Framingham risk score in postmenopausal women. Maturitas. 2015; 82(4): 431–35. https://doi.org/10.1016/j.maturitas.2015.07.011. PMID: 26385536.
  25. Ley S.H., Li Y., Tobias D.K. et al. Duration of reproductive life span, age at menarche, and age at menopause are associated with risk of cardiovascular disease in women. J Am Heart Assoc. 2017; 6(11): e006713. https://doi.org/10.1161/jaha.117.006713. PMID: 29097389. PMCID: PMC5721766.
  26. Roach R.E., Helmerhorst F.M., Lijfering W.M. et al. Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke. Cochrane Database Syst Rev. 2015; 2015(8): CD011054. https://doi.org/10.1002/14651858.CD011054.pub2. PMID: 26310586. PMCID: PMC6494192.
  27. Plu-Bureau G., Hugon-Rodin J., Maitrot-Mantelet L., Canonico M. Hormonal contraceptives and arterial disease: An epidemiological update. Best Pract Res Clin Endocrinol Metab. 2013; 27(1): 35–45. https://doi.org/10.1016/j.beem.2012.11.003. PMID: 23384744.
  28. Chan W.S., Ray J., Wai E.K. et al. Risk of stroke in women exposed to low-dose oral contraceptives: A critical evaluation of the evidence. Arch Intern Med. 2004; 164(7): 741–47. https://doi.org/10.1001/archinte.164.7.741. PMID: 15078643.
  29. Baillargeon J.P., McClish D.K., Essah P.A., Nestler J.E. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: A meta-analysis. J Clin Endocrinol Metab. 2005; 90(7): 3863–70. https://doi.org/10.1210/jc.2004-1958. PMID: 15814774.
  30. Lidegaard Ø., Løkkegaard E., Jensen A. et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med. 2012; 366(24): 2257–66. https://doi.org/10.1056/NEJMoa1111840. PMID: 22693997.
  31. Chakhtoura Z., Canonico M., Gompel A. et al. Progestogen-only contraceptives and the risk of stroke: A meta-analysis. Stroke. 2009; 40(4): 1059–62. https://doi.org/10.1161/strokeaha.108.538405. PMID: 19211491.
  32. Schürks M., Rist P.M., Bigal M.E. et al. Migraine and cardiovascular disease: Systematic review and meta-analysis. BMJ. 2009; 339: b3914. https://doi.org/10.1136/bmj.b3914. PMID: 19861375. PMCID: PMC2768778.
  33. Bousser M.G., Conard J., Kittner S. et al. Recommendations on the risk of ischaemic stroke associated with use of combined oral contraceptives and hormone replacement therapy in women with migraine. The International Headache Society Task Force on Combined Oral Contraceptives & Hormone Replacement Therapy. Cephalalgia. 2000; 20(3): 155–56. https://doi.org/10.1046/j.1468-2982.2000.00035.x. PMID: 10997767.
  34. Grodstein F., Manson J.E., Stampfer M.J., Rexrode K. Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med. 2008; 168(8): 861–66. https://doi.org/10.1001/archinte.168.8.861. PMID: 18443262. PMCID: PMC4001717.
  35. Wassertheil-Smoller S., Hendrix S.L., Limacher M. et al. Effect of estrogen plus progestin on stroke in postmenopausal women: The Women’s Health Initiative: A randomized trial. JAMA. 2003; 289(20): 2673–84. https://doi.org/10.1001/jama.289.20.2673. PMID: 12771114.
  36. Hendrix S.L., Wassertheil-Smoller S., Johnson K.C. et al. Effects of conjugated equine estrogen on stroke in the Women’s Health Initiative. Circulation. 2006; 113(20): 2425–34. https://doi.org/10.1161/circulationaha.105.594077. PMID: 16702472.
  37. Rossouw J.E., Prentice R.L., Manson J.E. et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA. 2007; 297(13): 1465–77. https://doi.org/10.1001/jama.297.13.1465. PMID: 17405972.
  38. Grodstein F., Manson J.E., Stampfer M.J., Rexrode K. Postmenopausal hormone therapy and stroke: Role of time since menopause and age at initiation of hormone therapy. Arch Intern Med. 2008; 168(8): 861–66. https://doi.org/10.1001/archinte.168.8.861. PMID: 18443262. PMCID: PMC4001717.
  39. Simon J.A., Hsia J., Cauley J.A. et al. Postmenopausal hormone therapy and risk of stroke: The Heart and Estrogen-progestin Replacement Study (HERS). Circulation. 2001; 103(5): 638–42. https://doi.org/10.1161/01.cir.103.5.638. PMID: 11156873.
  40. Viscoli C.M., Brass L.M., Kernan W.N. et al. A clinical trial of estrogen-replacement therapy after ischemic stroke. N Engl J Med. 2001; 345(17): 1243–49. https://doi.org/10.1056/NEJMoa010534. PMID: 11680444.
  41. Crissman H.P., Berger M.B., Graham L.F., Dalton V.K. Transgender demographics: A household probability sample of US Adults, 2014. Am J Public Health. 2017; 107(2): 213–15. https://doi.org/10.2105/AJPH.2016.303571. PMID: 27997239. PMCID: PMC5227939.
  42. Chipkin S.R., Kim F. Ten most important things to know about caring for transgender patients. Am J Med. 2017; 130(11): 1238–45. https://doi.org/10.1016/j.amjmed.2017.06.019. PMID: 28716460.
  43. Boardman H.M., Hartley L., Eisinga A. et al. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev. 2015; 2015(3): CD002229. https://doi.org/10.1002/14651858.CD002229.pub4. PMID: 25754617. PMCID: PMC10183715.
  44. Shatzel J.J., Connelly K.J., DeLoughery T.G. Thrombotic issues in transgender medicine: A review. Am J Hematol. 2017; 92(2): 204–8. https://doi.org/10.1002/ajh.24593. PMID: 27779767
  45. van Kesteren P.J., Asscheman H., Megens J.A., Gooren L.J. Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clin Endocrinol (Oxf). 1997; 47(3): 337–42. https://doi.org/10.1046/j.1365-2265.1997.2601068.x. PMID: 9373456.
  46. Wierckx K., Elaut E., Declercq E. et al. Prevalence of cardiovascular disease and cancer during cross-sex hormone therapy in a large cohort of trans persons: a case-control study. Eur J Endocrinol. 2013; 169(4): 471–78. https://doi.org/10.1530/EJE-13-0493. PMID: 23904280.
  47. Asscheman H., Giltay E.J., Megens J.A. et al. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol. 2011; 164(4): 635–42. https://doi.org/10.1530/EJE-10-1038. PMID: 21266549.
  48. Gooren L.J., Wierckx K., Giltay E.J. Cardiovascular disease in transsexual persons treated with cross-sex hormones: Reversal of the traditional sex difference in cardiovascular disease pattern. Eur J Endocrinol. 2014; 170(6): 809–19. https://doi.org/10.1530/EJE-14-0011. PMID: 24616414.
  49. Sharshar T., Lamy C., Mas J.L. Incidence and causes of strokes associated with pregnancy and puerperium. A study in public hospitals of Ile de France. Stroke in Pregnancy Study Group. Stroke. 1995; 26(6): 930–36. https://doi.org/10.1161/01.str.26.6.930. PMID: 7762040.
  50. Kittner S.J., Stern B.J., Feeser B.R. et al. Pregnancy and the risk of stroke. N Engl J Med. 1996; 335(11): 768–74. https://doi.org/10.1056/NEJM199609123351102. PMID: 8703181. PMCID: PMC1479545.
  51. Salonen Ros H., Lichtenstein P., Bellocco R. et al. Increased risks of circulatory diseases in late pregnancy and puerperium. Epidemiology. 2001; 12(4): 456–60. https://doi.org/10.1097/00001648-200107000-00016. PMID: 11416782.
  52. Del Zotto E., Giossi A., Volonghi I. et al. Ischemic stroke during pregnancy and puerperium. Stroke Res Treat. 2011; 2011: 606780. https://doi.org/10.4061/2011/606780. PMID: 21331336. PMCID: PMC3038679.
  53. van Alebeek M.E., de Heus R., Tuladhar A.M., de Leeuw F.E. Pregnancy and ischemic stroke: a practical guide to management. Curr Opin Neurol. 2018; 31(1): 44–51. https://doi.org/10.1097/WCO.0000000000000522. PMID: 29120921.
  54. Roth J., Deck G. Neurovascular disorders in pregnancy: A review. Obstet Med. 2019; 12(4): 164–67. https://doi.org/10.1177/1753495X19825699. PMID: 31853255. PMCID: PMC6909296.
  55. Ban L., Sprigg N., Abdul Sultan A. et al. Incidence of first stroke in pregnant and nonpregnant women of childbearing age: A population-based cohort study from England. J Am Heart Assoc. 2017; 6(4): e004601. https://doi.org/10.1161/jaha.116.004601. PMID: 28432074. PMCID: PMC5532991.
  56. Kamel H., Navi B.B., Sriram N. et al. Risk of a thrombotic event after the 6-week postpartum period. N Engl J Med. 2014; 370(14): 1307–15. https://doi.org/10.1056/nejmoa1311485. PMID: 24524551. PMCID: PMC4035479.
  57. Dunbar M., Kirton A. Perinatal stroke. Semin Pediatr Neurol. 2019; 32: 100767. https://doi.org/10.1016/j.spen.2019.08.003. PMID: 31813521.
  58. Roeder H.J., Lopez J.R., Miller E.C. Ischemic stroke and cerebral venous sinus thrombosis in pregnancy. Handb Clin Neurol. 2020; 172: 3–31. https://doi.org/10.1016/B978-0-444-64240-0.00001-5. PMID: 32768092. PMCID: PMC7528571.
  59. Opaskar A., Massaquoi R., Sila C. Stroke in pregnancy. Handb Clin Neurol. 2021; 177: 283–93. https://doi.org/10.1016/B978-0-12-819814-8.00032-9. PMID: 33632448.
  60. Santos M., de Sousa D.A. Cerebrovascular disease in pregnancy and postpartum. Curr Opin Neurol. 2022; 35(1): 31–38. https://doi.org/10.1097/wco.0000000000001005. PMID: 34812747.
  61. Miller E.C., Yaghi S., Boehme A.K. et al. Mechanisms and outcomes of stroke during pregnancy and the postpartum period: A cross-sectional study. Neurol Clin Pract. 2016; 6(1): 29–39. https://doi.org/10.1212/cpj.0000000000000214. PMID: 26918201. PMCID: PMC4753832.
  62. Miller E.C., Gatollari H.J., Too G. et al. Risk factors for pregnancy-associated stroke in women with preeclampsia. Stroke. 2017; 48(7): 1752–59. https://doi.org/10.1161/strokeaha.117.017374. PMID: 28546324. PMCID: PMC5539968.
  63. Zambrano M.D., Miller E.C. Maternal stroke: An update. Curr Atheroscler Rep. 2019; 21(9): 33. https://doi.org/10.1007/s11883-019-0798-2. PMID: 31230137. PMCID: PMC6815220.
  64. Lucia M., Viviana M., Alba C. et al. Neurological complications in pregnancy and the puerperium: methodology for a clinical diagnosis. J Clin Med. 2023; 12(8): 2994. https://doi.org/10.3390/jcm12082994. PMID: 37109329. PMCID: PMC10141482.
  65. Mayama M., Uno K., Tano S., Yoshihara M. et al. Incidence of posterior reversible encephalopathy syndrome in eclamptic and patients with preeclampsia with neurologic symptoms. Am J Obstet Gynecol. 2016; 215(2): 239.e1–5. https://doi.org/10.1016/j.ajog.2016.02.039. PMID: 26902987.
  66. Arora G., Sahni N. Anesthetic management of a patient with Sheehan’s syndrome and twin pregnancy while undergoing a cesarean section. J Postgrad Med. 2020; 66(1): 51–53. https://doi.org/10.4103/jpgm.JPGM_473_19. PMID: 31929313. PMCID: PMC6970334.
  67. Bushnell C., McCullough L.D., Awad I.A. et al. Guidelines for the prevention of stroke in women: A statement for healthcare professionals from the American Heart Association / American Stroke Association. Stroke. 2014; 45(5): 1545–88. https://doi.org/10.1161/01.str.0000442009.06663.48. PMID: 24503673. PMCID: PMC10152977.
  68. Bonamy A.K., Parikh N.I., Cnattingius S. et al. Birth characteristics and subsequent risks of maternal cardiovascular disease: effects of gestational age and fetal growth. Circulation. 2011; 124(25): 2839–46. https://doi.org/10.1161/circulationaha.111.034884. PMID: 22124377.
  69. Lamy C., Hamon J.B., Coste J., Mas J.L. Ischemic stroke in young women: risk of recurrence during subsequent pregnancies. French Study Group on Stroke in Pregnancy. Neurology. 2000; 55(2): 269–74. https://doi.org/10.1212/wnl.55.2.269. PMID: 10908903.
  70. Coppage K.H., Hinton A.C., Moldenhauer J. et al. Maternal and perinatal outcome in women with a history of stroke. Am J Obstet Gynecol. 2004; 190(5): 1331–34. https://doi.org/10.1016/j.ajog.2003.11.002. PMID: 15167838.
  71. Crovetto F., Ossola M.W., Spadaccini G. et al. Ischemic stroke recurrence during pregnancy: a case series and a review of the literature. Arch Gynecol Obstet. 2012; 286(3): 599–604. https://doi.org/10.1007/s00404-012-2352-0. PMID: 22546951.
  72. Putaala J., Haapaniemi E., Metso A.J. et al. Recurrent ischemic events in young adults after first-ever ischemic stroke. Ann Neurol. 2010; 68(5): 661–71. https://doi.org/10.1002/ana.22091. PMID: 21031581.
  73. Liu X.J., Wang S., Zhao Y.L. et al. Risk of cerebral arteriovenous malformation rupture during pregnancy and puerperium. Neurology. 2014; 82(20): 1798–803. https://doi.org/10.1212/wnl.0000000000000436. PMID: 24759847. PMCID: PMC4035708.
  74. Porras J.L., Yang W., Philadelphia E. et al. Hemorrhage risk of brain arteriovenous malformations during pregnancy and puerperium in a North American cohort. Stroke. 2017; 48(6): 1507–13. https://doi.org/10.1161/strokeaha.117.016828. PMID: 28487334.
  75. Wakasa T., Ishibashi-Ueda H., Takeuchi M. Maternal death analysis based on data from the nationwide registration system inJapan (2010–2018). Pathol Int. 2021; 71(4): 223–31. https://doi.org/10.1111/pin.13076. PMID: 33559265. PMCID: PMC8248185.
  76. Warner E.D., Farhan S., Bierowski M. et al. Trends in cardiovascular complications of pregnancy: A nationwide inpatient sample analysis. Am J Med Sci. 2023; 366(5): 337–46. https://doi.org/10.1016/j.amjms.2023.09.001. PMID: 37678669.
  77. Hensley J.G., Shviraga B.A. Metastastic choriocarcinoma in a term pregnancy: A case study. MCN Am J Matern Child Nurs. 2014; 39(1): 8–15; quiz 16–7. https://doi.org/10.1097/NMC.0b013e3182a8de5b. PMID: 24076744.
  78. Picone O., Castaigne V., Ede C., Fernandez H. Cerebral metastases of a choriocarcinoma during pregnancy. Obstet Gynecol. 2003; 102(6): 1380–83. https://doi.org/10.1016/s0029-7844(03)00865-2. PMID: 14662230.

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