Which hypercoagulable states increase the risk of stroke during pregnancy?

Updated: Nov 08, 2018
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

Antiphospholipid antibody syndrome is associated with stroke in young women and with SLE and other collagen-vascular diseases. The patient’s medical history is important for diagnosing the disorder and should include a pertinent history of spontaneous abortions or intrauterine fetal demise (especially if multiple), thrombotic events, a family history of stroke or antiphospholipid antibody syndrome, and thrombocytopenia. Treatment usually consists of anticoagulation. [72] (See Antiphospholipid Antibody Syndrome and Pregnancy.)

Other hypercoagulable states that occur in young women include the following:

  • Antithrombin III deficiency

  • Protein C or S deficiencies

  • Resistance to activated protein C

  • Dysfibrinogenemia

  • Homocystinemia

  • Plasminogen and plasminogen-activator deficiency

Because pregnancy itself results in a hypercoagulable state, the risk for thrombotic events increases in patients with a known preexisting hypercoagulable condition. These disorders should also be considered in young women with stroke and should be investigated if suspected. [69, 72]


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