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Pregnancy-Related Stroke: A Review
Tucker Doiron1, Abigail Ramseyer2, Emily N Phelps3
1Resident.
Obstetrical & Gynecological Survey
|June 7, 2022
Summary
Maternal strokes, a leading cause of death and disability, require prompt identification and management. This review details stroke diagnosis and treatment in pregnancy to reduce adverse outcomes.
Area of Science:
- Neurology
- Obstetrics
- Public Health
Background:
- Stroke is a significant risk in pregnancy, contributing to maternal mortality and neurological disability.
- Approximately 30 in 100,000 pregnancies are affected by stroke in the US.
- Obstetric care providers must be adept at identifying, diagnosing, and managing strokes during pregnancy.
Purpose of the Study:
- To provide an evidence-based review of stroke in pregnancy.
- To outline diagnostic and management strategies for strokes complicating pregnancy.
Main Methods:
- A comprehensive literature search was conducted on PubMed.
- Search terms included "stroke," "cerebrovascular accident," "intracranial hemorrhage," and pregnancy-related complications, risk factors, management, and outcomes.
- Articles published between 2000 and 2020 were reviewed, with 90 selected for this analysis.
Main Results:
- Common stroke symptoms in pregnancy include headache, neurological deficits, seizures, and visual changes.
- Diagnosis utilizes computed tomography (CT) scans with shielding or magnetic resonance imaging (MRI) without contrast.
- Ischemic stroke management involves reperfusion therapy (IV t-PA, thrombolysis, thrombectomy); hemorrhagic stroke treatment is guided by severity and location.
Conclusions:
- Early recognition and effective management are crucial for reducing stroke-related morbidity and mortality in pregnant individuals.
- This review synthesizes current knowledge on diagnosing and managing pregnancy-associated strokes.
