Guidelines for stroke management in pregnancy

Diana Aguiar de Sousa, MD, PhD, Lisbon Central University Hospital Center, University of Lisbon, Lisbon, Portugal, shares the latest recommendations for diagnosis and treatment of stroke in pregnant women. Pregnant women are at an increased risk of stroke, with the incidence around 3 times higher than in young adults outside of pregnancy. Upon presentation, non-contrast head CT should be conducted, as risk to the fetus has been shown to be minimal. Concerning acute treatment during pregnancy, the recommended decision-making process is similar to that of non-pregnant individuals, but additional considerations must be made, including increased bleeding risk and risk of radiation exposure to the fetus. Increasing evidence supports the role of intravenous thrombolysis and endovascular therapy in eligible pregnant women. The use of therapeutic anticoagulation during acute management is not indicated due to the increased bleeding risk. This interview took place at the ESOC 2022 congress in Lyon, France.