Ding Jia Jennifer, Mitta Srilakshmi, Kole-White Martha, Roth Julie, Malhamé Isabelle
Department of Obstetrics and Gynecology, Brown/Women and Infants Hospital, Providence, RI, USA.
Department of Obstetric and Consultative Medicine, Brown/Women and Infants Hospital of Rhode Island, Providence, RI, USA.
Obstet Med. 2024 Dec;17(4):208-212. doi: 10.1177/1753495X231213437. Epub 2023 Nov 17.
The preventability of strokes during pregnancy and postpartum is understudied.
We identified patients with ischemic and hemorrhagic strokes in pregnancy or within 12 weeks postpartum between 2009 and 2020 at an obstetric teaching hospital. We described the clinical course of the included cases. A multi-disciplinary panel adjudicated each occurrence of stroke according to a modified classification system for preventability.
Fifteen patients experienced a stroke during pregnancy or postpartum. Precisely, 60% presented with a headache, and 47% of events were complicated by severe obstetrical hypertension. Two cases were thought to be "possibly preventable" due to delays in presentation to care and miscommunication regarding hypertension management goals.
In a cohort of pregnant and postpartum patients with stroke at a tertiary-care center, strokes may be prevented by future initiatives focusing on patient and provider education regarding early warning signs of pregnancy-associated stroke and hypertension thresholds and management specific to pregnancy.
孕期和产后中风的可预防性研究不足。
我们在一家产科教学医院中，识别出2009年至2020年期间孕期或产后12周内发生缺血性和出血性中风的患者。我们描述了纳入病例的临床病程。一个多学科小组根据改良的可预防性分类系统对每一次中风事件进行判定。
15名患者在孕期或产后发生了中风。确切地说，60%的患者出现头痛，47%的事件并发严重产科高血压。由于就诊延迟以及高血压管理目标方面的沟通失误，有2例被认为“可能可预防”。
在一家三级医疗中心的孕期和产后中风患者队列中，未来通过针对患者和医护人员开展关于妊娠相关中风早期预警信号、高血压阈值以及孕期特定管理的教育举措，中风可能得以预防。
