Stroke and pregnancy: What to look for

Stephanie Paolini, MD

Neurology

Although stroke is rare among women of child bearing age, the risk for stroke increases three-fold during pregnancy and the postpartum period, with the early postpartum period having the highest risk. Neurologist Stephanie Paolini, MD, explained what to look for.

Stroke symptoms during and after pregnancy

Stroke symptoms during pregnancy may be similar to those outside of pregnancy. It’s important to call 911 immediately if you experience any of the following:

• Sudden onset of weakness or numbness on one side of the face or body
• Speech difficulty
• Vision changes or loss of vision
• Severe headache

What are the risk factors?

“Pregnancy itself is a risk factor for stroke,” said Dr. Paolini. “The body develops a tendency to clot as pregnancy progresses which is important to prevent life threatening bleeding at the time of delivery, but it also increases the risk of stroke. High blood pressure during pregnancy further increases this risk and is the biggest cause of strokes during pregnancy. Severe high blood pressure may lead to preeclampsia or eclampsia.”

Other stroke risk factors include:

• High cholesterol
• Diabetes
• Irregular heart rhythm (atrial fibrillation)
• Clotting disorders
• Tobacco use

Being as healthy as possible prior to pregnancy reduces the risk of stroke associated with pregnancy.

What can you to do prevent a stroke?

OB/GYN physicians will carefully monitor for high blood pressure during pregnancy and treat if needed. Patients may be instructed to take a baby aspirin or blood thinner during pregnancy, depending on risk factors. “We recommend staying active and eating a healthy diet as well,” said Dr. Paolini.

“Remember, time is brain. If stroke symptoms appear, patients should call 911 and arrive in the emergency room as fast as possible. Treatments such as clot-busting medication and clot retrieval are most effective when performed early,” she said.