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Ginecologia y Obstetricia de Mexico 2009-Mar

[Chorea gravidarum. A case report].

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Fernando Germes Piña

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Chorea gravidarum is an uncommon condition characterized by involuntary movements, speaking alterations and in the affective status during first trimester pregnancy, the incidence is 1 by each 2275 pregnancies, it is self limiting and resolves when the pregnancy ends, most of the cases are idiopathic and the rest is associated to the antiphospholipid syndrome, rheumatic fever, thyrotoxicosis, systemic lupus erythematosus, syphilis, Huntington disease or induced by drugs. The recurrences can occur in the subsequent pregnancies. The dopamine antagonists as the haloperidol and the chlorpromazine are useful to control the symptoms and are safe at lower doses. A 22 years-old patient, second pregnancy, without prenatal care, who was admitted to the labor at 36.1 weeks of gestation and psychosis of pregnancy presenting involuntary movements, dysnea and behavior disorder of three days evolution. The initial treatment was with diazepam, two days after the patient presented amniotic rupture without uterine activity, the pregnancy was interrupted by C- section and a male newborn was obtained. She had a favorable evolution during puerperium. She was discharged of the hospital four days later, having only abnormal movement in the right hand. Antistreptolysins antibodies of 333, PCR 1:80 and negative rheumatoid factor. She had four normal pregnancies more after, being the last the 10th of February of 2007.

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