Title: Stroke and Pregnancy: What's Different?<br/>Author: Danya Khoujah<br/><a href='http://umem.org/profiles/faculty/739/'>[Click to email author]</a><hr/><p>
<!--?xml version="1.0" encoding="UTF-8"?--></p>
<ul>
<li>
<span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The incidence of stroke (both ischemic and hemorrhagic) in pregnant and peripartum women is <i style="font-size: 14px; font-family: 'Helvetica Neue'; font-weight: bold;">three times</i> age-matched controls. This increased risk is mostly in the 3rd trimester and up to 16 weeks postpartum. </span></span></li>
</ul>
<ul>
<li>
<span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Consider other causes of stroke: <span style="line-height: normal;">posterior reversible encephalopathy syndrome (PRES), reversible cerebral vasoconstriction syndrome, cerebral venous sinus thrombosis <span style="line-height: normal;">and <span style="line-height: normal;">cardioembolic stroke fro</span></span></span>m peripartum cardiomyopathy.</span></span></li>
</ul>
<ul>
<li>
<span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="line-height: normal;">CTs carry some risk due to the ionizing radiation, but with abdominal and pelvic shielding the exposure to the fetus is very low. MRIs do not carry that risk, but Gadolinium is <i style="font-weight: bold;">absolutely contraindicated</i> in pregnancy as it deposits in fetal tissue. </span></span></span></li>
</ul>
<ul>
<li>
<span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><span style="line-height: normal;">Pregnancy is a relative (not absolute) contraindication for tPA.</span></span></span></li>
</ul>
<fieldset><legend>References</legend>
<p>
<!--?xml version="1.0" encoding="UTF-8"?--><font face="Helvetica Neue" style="font-size: 14px;">Majerisk JJ. Inherited and Uncommon Causes of Stroke. <span style="line-height: normal;"><i>Continuum</i></span><span style="line-height: normal;"> 2017;23(1):211–237.</span></font></p>
</fieldset>