Pregnancy‐Associated Stroke

• Published in: Journal of midwifery & women's health 2018-01, Vol.63 (1), p.23-32
• Main Authors: Sanders, Bethany D., Davis, Melissa G., Holley, Sharon L., Phillippi, Julia C.
• Format: Article
• Language: English
• Subjects: Brain; cerebrovascular accident; Death & dying; Disease prevention; Female; gestational hypertension; Health risk assessment; hematologic changes of pregnancy; hemorrhagic stroke; Humans; Hypertension; Ischemia; ischemic stroke; Medical diagnosis; Morbidity; Mortality; Nursing; Pathophysiology; Patient assessment; Perinatal care; Postnatal Care; Postpartum Period; Postpartum women; Preeclampsia; Pregnancy; Primary care; Primary Health Care; Puerperal Disorders - therapy; Risk assessment; Risk Factors; Stroke; Stroke - etiology; Stroke - therapy; Thromboembolism; transient ischemic attack; venous thromboembolism; Womens health
• ISSN: 1526-9523; 1542-2011
• DOI: 10.1111/jmwh.12720

Cerebrovascular accident, or stroke, is the fourth leading cause of death for all women and the eighth leading cause of pregnancy‐associated death. The physiologic changes of pregnancy increase the risk of cerebrovascular accident for women. With current incidence rates, a facility with 3300 births per year can anticipate caring for one woman with a pregnancy‐related stroke at least every 2 years. All maternity care providers must be able to assess women experiencing stroke‐like symptoms and initiate timely care to mitigate brain tissue damage, decrease long‐term morbidity, and prevent mortality. The 2 main types of stroke, ischemic and hemorrhagic, have similar presenting symptoms but very different pathophysiology and treatment. This article reviews assessment and initial treatment of pregnant and postpartum women experiencing stroke and provides guidance for subsequent maternity and primary care to assist front‐line perinatal care providers who may be the first to treat affected women or may resume primary care after diagnosis.