Intravenous Thrombolysis for Stroke in First-Trimester Pregnancy: A Case Report

The use of thrombolytic therapy during pregnancy remains a source of concern and stress. In pregnant patients who meet the criteria, thrombolytic therapy is recommended when the expected benefits outweigh the risks.

A 33-year-old pregnant woman in her first trimester presented with an acute-onset impairment of speech and comprehension. Her initial National Institutes of Health Stroke Scale score was 4. Diffusion MRI was compatible with cortical-subcortical acute ischemia in the left frontotemporal region. Intravenous thrombolytic therapy was administered to the patient who met the criteria for thrombolysis. No bleeding or other complications were observed after treatment. On examination, after one week, all symptoms had completely resolved. The pregnancy ended in fetal abortion at 16 weeks; the cause was not determined.

Publication of case reports on the complications and efficacy of IVT during pregnancy is important, since there are no controlled studies of thrombolytic therapy in pregnant women.