Stroke: How to manage stroke during pregnancy?

Acute ischemic stroke (AIS) is a devastating, albeit rare, complication associated with pregnancy and early postpartum

The mechanisms that pregnant women are prone to cerebral infarction include changes in hemodynamic factors and venous stasis, which contribute to the formation of a physiological state of hypercoagulability

Because pregnant women and postpartum women are systematically excluded from clinical trials that validate acute reperfusion therapy for AIS, there is little literature and evidence about the efficacy of these treatments

In most case reports and small single-institution series, only one large-scale study evaluated acute reperfusion therapy for intravascular thrombectomy during pregnancy and postpartum

In addition, this evaluation was carried out before the publication of clinical trial data in 2015, which verified the effectiveness of MT in the general stroke population

In view of the fact that since these landmark clinical trials were published in 2015, the number of people using endovascular treatment of AIS has been increasing, and there is a large amount of evidence to illustrate its clinical success in the treatment of anterior circulation and great vessel occlusion in the general population,

In this way, Alis J.

From 2012 to 2018, they conducted a query on a sample of inpatients across the country to identify and describe AIS pregnant women and postpartum patients treated with MT (within 6 weeks postpartum)

Among the 4590 pregnant and postpartum AIS patients, 180 (3.

Compared with non-pregnant AIS patients who received MT, their rates of intracranial hemorrhage (11% vs.

After adjusting for multivariate analysis of age, disease severity, and stroke severity, pregnancy/postpartum status was independently associated with a lower likelihood of intracranial hemorrhage (adjusted odds ratio, 0.

After matching the propensity score, pregnant women and postpartum patients receiving MT and drug-treated patients experienced venous thromboembolism (17% vs.

Pregnant women and postpartum women who received MT treatment did not die or miscarried during their hospitalization

This large-scale analysis using national claims data shows that MT is a safe and effective treatment for AIS during pregnancy and postpartum

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