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Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy
Richard H Swartz1,2, Noor Niyar N Ladhani1,3, Norine Foley4,5
11 Sunnybrook Health Sciences Centre, Toronto, Canada.
Summary
This consensus statement provides guidance for secondary stroke prevention in pregnant women with a history of stroke or transient ischemic attack (TIA). It emphasizes tailored management strategies to ensure maternal and fetal health while minimizing recurrent stroke risks.
Area of Science:
- Neurology
- Obstetrics
- Cardiology
Background:
- Stroke is rare in pregnant women with prior stroke history, but pregnancy increases risk.
- Existing guidelines lack stroke-specific recommendations for this unique patient group.
- Maternal health is crucial for fetal well-being, necessitating integrated care approaches.
Framework:
- Consensus statement based on best available literature and expert opinion.
- Integrates management decisions for non-pregnant patients and those without prior stroke.
- Focuses on a tailored approach considering both maternal and fetal health.
Implementation:
- Addresses general secondary stroke prevention strategies during pregnancy.
- Covers antithrombotic therapy, blood pressure, lipid, and diabetes management.
- Includes management of specific ischemic stroke etiologies in pregnancy.
Implications:
- Aims to minimize recurrent stroke risk in pregnant women with a history of stroke.
- Provides guidance for healthcare professionals across disciplines.
- Supports informed counseling, monitoring, and safe pharmacotherapy choices.
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