Pregnancy and Stroke Risk in Women

Jessica Tate; Cheryl Bushnell

Disclosures

Women's Health. 2011;7(3):363-374. 

In This Article

Future Perspective

There are many gaps in our knowledge about pregnancy-related stroke, including detailed knowledge about mechanisms and outcomes post-hospital discharge. Although administrative databases allow estimation of incidence and prevalence, the patient-level detail is lacking. Therefore, in order to better understand pregnancy-related stroke causes and outcomes, the development of multisite, multidisciplinary registries are needed. In addition, it seems likely that in the next 5–10 years, more pregnant women with acute stroke will be treated with rtPA as neurologists and interventional radiologists develop new or improved imaging strategies (e.g., MRI perfusion) to identify women who would clearly benefit from reperfusion while minimizing risk to the fetus. In the next couple of years, new anticoagulants, such as direct thrombin inhibitors (dabigatran),[48] may be used in pregnancy, especially for women who cannot receive heparin or warfarin. Dabigatran is currently US FDA category C for pregnant women, but more testing in humans will be required in order to determine the number of adverse pregnancy outcomes and the risk–benefit ratio for preventing stroke and CVT during pregnancy.

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