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Preventability of stroke during pregnancy and postpartum
Jia Jennifer Ding1, Srilakshmi Mitta2, Martha Kole-White3
1Department of Obstetrics and Gynecology, Brown/Women and Infants Hospital, Providence, RI, USA.
Obstetric Medicine
|December 6, 2024
Summary
Pregnancy-associated strokes are understudied. Two of fifteen cases reviewed were possibly preventable, highlighting the need for better education on early warning signs and hypertension management during pregnancy and postpartum.
Area of Science:
- Obstetrics and Gynecology
- Neurology
- Public Health
Background:
- The preventability of strokes occurring during pregnancy and the postpartum period remains an understudied area.
- Pregnancy-associated stroke is a significant concern with potential for preventable morbidity and mortality.
Purpose of the Study:
- To investigate the clinical course and preventability of strokes in pregnant and postpartum patients.
- To identify factors contributing to stroke occurrence and potential for prevention in this population.
Main Methods:
- A retrospective review of ischemic and hemorrhagic stroke cases in pregnant or postpartum patients (2009-2020) at an obstetric teaching hospital.
- Clinical courses were described, and a multidisciplinary panel adjudicated stroke preventability using a modified classification system.
Main Results:
- Fifteen stroke cases were identified during pregnancy or within 12 weeks postpartum.
- Common symptoms included headache (60%), and severe obstetrical hypertension complicated 47% of events.
- Two cases were deemed "possibly preventable" due to delayed presentation and communication issues regarding hypertension management.
Conclusions:
- Future initiatives should focus on educating patients and providers about early warning signs of pregnancy-associated stroke.
- Improved understanding and management of hypertension thresholds specific to pregnancy are crucial for stroke prevention.
- Targeted education can potentially reduce the incidence of preventable strokes in pregnant and postpartum individuals.
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