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Published on: January 26, 2024
Stroke in pregnancy
Valerie Arias1, Ilayda Yilmaz Soylu2, Eliza C Miller2
1Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
Summary
Pregnancy triples stroke risk due to physiological changes. Understanding pregnancy-associated vasculopathy, including preeclampsia, is key for managing maternal stroke and improving outcomes.
Area of Science:
- Neurology
- Obstetrics
- Cardiology
Background:
- Pregnancy and postpartum physiological changes disrupt cerebrovascular homeostasis.
- Maternal stroke, though rare, significantly increases morbidity and mortality.
- Stroke risk is tripled during pregnancy and the postpartum period.
Purpose of the Study:
- Review physiological changes during pregnancy that affect cerebrovascular homeostasis.
- Discuss pregnancy-associated syndromes predisposing to stroke.
- Provide practical considerations for managing pregnancy-related stroke.
Main Methods:
- Literature review of physiological changes in pregnancy.
- Analysis of pregnancy-associated syndromes and stroke mechanisms.
- Synthesis of clinical considerations for diagnosis and management.
Main Results:
- Pregnancy-associated stroke mechanisms are diverse, including cardioembolism, vasculopathies, and hemorrhage.
- Hypertensive disorders of pregnancy and stroke may share mechanisms related to endothelial dysfunction and sympathetic hyperactivity.
- Pregnancy-associated vasculopathy may represent a continuum.
Conclusions:
- Pregnancy-associated stroke requires specialized understanding due to unique physiological changes.
- Early recognition and management of conditions like preeclampsia are crucial.
- Further research into shared mechanisms can guide prevention and treatment strategies.
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