Mariel G Kozberg1, Erica C Camargo2. 1. Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. 2. Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. efaye@partners.org.
Abstract
PURPOSE OF REVIEW: Pregnancy places women at a higher risk for hemorrhagic and ischemic strokes. This review discusses the pathophysiological mechanisms underlying this increased risk, management considerations for pregnant patients, and ways to decrease the risk of stroke in this patient population. RECENT FINDINGS: Rates of ischemic and hemorrhagic pregnancy-associated stroke have increased over the past 20 years, particularly events associated with hypertensive disorders of pregnancy. There is a growing body of evidence supporting the use of acute reperfusion therapies in ischemic pregnancy-associated stroke including tissue plasminogen activator (tPA) and endovascular thrombectomy. While the unique physiology of pregnancy places women at a higher risk of stroke, acute ischemic stroke management in pregnant patients should closely mirror the management of non-pregnant patients. Secondary stroke prevention agents should be selected with consideration of the pregnancy.
PURPOSE OF REVIEW: Pregnancy places women at a higher risk for hemorrhagic and ischemic strokes. This review discusses the pathophysiological mechanisms underlying this increased risk, management considerations for pregnant patients, and ways to decrease the risk of stroke in this patient population. RECENT FINDINGS: Rates of ischemic and hemorrhagic pregnancy-associated stroke have increased over the past 20 years, particularly events associated with hypertensive disorders of pregnancy. There is a growing body of evidence supporting the use of acute reperfusion therapies in ischemic pregnancy-associated stroke including tissue plasminogen activator (tPA) and endovascular thrombectomy. While the unique physiology of pregnancy places women at a higher risk of stroke, acute ischemic stroke management in pregnant patients should closely mirror the management of non-pregnant patients. Secondary stroke prevention agents should be selected with consideration of the pregnancy.
Entities:
Keywords:
Ischemic stroke; Maternal stroke; Pregnancy and cardiovascular disease
Authors: B T Bateman; H C Schumacher; C D Bushnell; J Pile-Spellman; L L Simpson; R L Sacco; M F Berman Journal: Neurology Date: 2006-08-08 Impact factor: 9.910
Authors: Jeffrey L Saver; Mayank Goyal; Alain Bonafe; Hans-Christoph Diener; Elad I Levy; Vitor M Pereira; Gregory W Albers; Christophe Cognard; David J Cohen; Werner Hacke; Olav Jansen; Tudor G Jovin; Heinrich P Mattle; Raul G Nogueira; Adnan H Siddiqui; Dileep R Yavagal; Blaise W Baxter; Thomas G Devlin; Demetrius K Lopes; Vivek K Reddy; Richard du Mesnil de Rochemont; Oliver C Singer; Reza Jahan Journal: N Engl J Med Date: 2015-04-17 Impact factor: 91.245
Authors: Michael A Belfort; Michael W Varner; Donna S Dizon-Townson; Charlotta Grunewald; Henry Nisell Journal: Am J Obstet Gynecol Date: 2002-09 Impact factor: 8.661
Authors: Justin Brewer; Michelle Y Owens; Kedra Wallace; Amanda A Reeves; Rachael Morris; Majid Khan; Babbette LaMarca; James N Martin Journal: Am J Obstet Gynecol Date: 2013-02-07 Impact factor: 8.661
Authors: Diana Aguiar de Sousa; Patrícia Canhão; Isabelle Crassard; Jonathan Coutinho; Antonio Arauz; Adriana Conforto; Yannick Béjot; Maurice Giroud; José M Ferro Journal: Stroke Date: 2017-10-03 Impact factor: 7.914
Authors: Junie P Warrington; Fan Fan; Sydney R Murphy; Richard J Roman; Heather A Drummond; Joey P Granger; Michael J Ryan Journal: Physiol Rep Date: 2014-08-28