Causes and Treatment of Acute Ischemic Stroke During Pregnancy

Causes and Treatment of Acute Ischemic Stroke During Pregnancy Purpose of review Treatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and preven- tion options, including associated risks specific to the pregnant and puerperal state. Recent findings Intravenous tissue plasminogen activator (tPA) and endovascular thrombectomy have been used successfully to treat pregnant women with acute ischemic stroke. Recent national guidelines recommend considering tPA use during pregnancy for moderate and severe strokes if the potential benefits offset the risks of uterine hemor- rhage. Summary Pregnancy-associated ischemic stroke is rare, but can be devastating, and recanalization therapy should not be systematically withheld. Women who are at risk for stroke should be followed carefully, and providers caring for pregnant women should be educated regarding stroke signs and symptoms. Many of the standard post stroke diag- nostic modalities may be used safely in pregnancy, and primary and secondary stroke prevention therapy must be tailored to avoid fetal toxicity. 21 Page 2 of 16 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Treatment Options in Neurology Springer Journals

Causes and Treatment of Acute Ischemic Stroke During Pregnancy

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Neurology; Intensive / Critical Care Medicine; Internal Medicine; Ophthalmology; General Practice / Family Medicine; Diabetes
ISSN
1092-8480
eISSN
1534-3138
D.O.I.
10.1007/s11940-018-0506-5
Publisher site
See Article on Publisher Site

Abstract

Purpose of review Treatment recommendations for pregnancy associated ischemic stroke are scarce. This may be due to the fact that, in general, obstetricians tend not to make recommendations for stroke patients and neurologists are not commonly involved in the care of pregnant women. Herein, we review the multiple etiologies of ischemic stroke during pregnancy, considerations for diagnostic testing, and acute treatment and preven- tion options, including associated risks specific to the pregnant and puerperal state. Recent findings Intravenous tissue plasminogen activator (tPA) and endovascular thrombectomy have been used successfully to treat pregnant women with acute ischemic stroke. Recent national guidelines recommend considering tPA use during pregnancy for moderate and severe strokes if the potential benefits offset the risks of uterine hemor- rhage. Summary Pregnancy-associated ischemic stroke is rare, but can be devastating, and recanalization therapy should not be systematically withheld. Women who are at risk for stroke should be followed carefully, and providers caring for pregnant women should be educated regarding stroke signs and symptoms. Many of the standard post stroke diag- nostic modalities may be used safely in pregnancy, and primary and secondary stroke prevention therapy must be tailored to avoid fetal toxicity. 21 Page 2 of 16

Journal

Current Treatment Options in NeurologySpringer Journals

Published: May 21, 2018

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