Management of stroke in pregnancy
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Management of stroke in pregnancy. Both CT and MRI are safe in pregnancy, Angiography may be used if indicated. Fully referenced neurology checklist.
Head imaging
- Both CT and MRI are safe in pregnancy
- Angiography may be used if indicated
- Gadolinium is contraindicated
- Iodine-based contrast agents are contraindicated: these impair neonatal thyroid function
Acute stroke treatment
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Secondary stroke prophylaxis
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Antihypertensive treatment
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Obstetric management
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Post-partum management
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Treatment of specific stroke types in pregnancy
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Acronyms
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References
- Sidorov EV, Feng W, Caplan LR. Stroke in pregnant and postpartum women. Expert Rev Cardiovasc Ther 2011; 9:1235-1247.
- Hacein-Bey L, Varelas PN, Ulmer JL, Mark LP, Raghavan K, Provenzale JM. Imaging of cerebrovascular disease in pregnancy and the puerperium. Am J Roentgenol 2016; 206:26-38.
- Landais A, Chaumont H, Dellis R. Thrombolytic therapy of acute ischemic stroke during early pregnancy. J Stroke Cerebrovasc Dis 2018; 27:e20-e23.
- Ryman KM, Pace WD, Smith S, Fontaine GV. Alteplase therapy for acute ischemic stroke in pregnancy: two case reports and a systematic review of the literature. Pharmacotherapy 2019; 39:767-774.
- Szuchy Kristiansen E, Holm Vestergaard H, Modrau B, Oppel LM. Acute ischemic stroke in late pregnancy treated with intravenous thrombolysis and endovascular therapy. Case Rep Neurol 2019; 11:41-46.
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