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Stroke in Pregnancy: ?A Consensus Statement by the Canadian Stroke Best Practices Stroke in Pregnancy Writing Group.

This consensus statement is focused on the issues of stroke prevention encountered by a woman who has had a stroke in the past and is now planning to become pregnant, is currently pregnant, or who has had a stroke in pregnancy but is beyond the hyperacute phase. We first address general management considerations from preconception counseling to pregnancy and post-partum including breastfeeding (Section 1). We then review management considerations for commonly used secondary prevention strategies (Section 2), including antithrombotic medications (both antiplatelets and anticoagulants), blood pressure management, lipid management and diabetes care. Finally, we address some of the more common specific causes of stroke that affect young women of childbearing age and pregnancy (Section 3) including cardioembolic stroke, cerebral venous sinus thrombosis and cerebral artery dissection.

Prevention of a first stroke in pregnancy is accomplished through general stroke primary risk reduction strategies and routine obstetrical care, especially management of hypertension in pregnancy (ref SOGC 2014 HTN guideline).

The management of a woman who experiences a stroke during pregnancy, including investigations and management, will be discussed in the second part of this Stroke in Pregnancy Consensus Statement series.

Goal: to provide guidance on the management of stroke in pregnancy based on a critical appraisal of current research evidence on obstetrical and stroke management and expert review and appraisal.

Scope: This document represents a consensus statement based on the process above, focused on the unique aspects of pregnancy-related stroke.? Many consensus statements are applicable to both ischemic and hemorrhagic stroke.? In cases where the statements are applicable to one type or the other, it will be explicitly noted.

Prevention and Pregnancy? Consensus Statement 2017 module contents:

Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy publication in the International Journal of Stroke

Citing the Secondary Prevention of Stroke during Pregnancy 2017 Module

Richard H Swartz (Co-First Author), Noor Niyar N. Ladhani (Co-First Author), ?Norine Foley, Kara Nerenberg, Simerpreet Bal, Jon Barrett, Cheryl Bushnell, Wee-Shian Chan,? Radha Chari, Dariush Dowlatshahi, Meryem El Amrani, Shital Gandhi, Gord Gubitz, Michael D Hill, Andra James, Thomas Jeerakathil, Albert Jin, Adam Kirton, Sylvain Lanthier,? Andrea Lausman, Lisa Rae Leffert? Jennifer? Mandzia,? Bijoy Menon, Aleksandra Pikula, Alexandre Poppe, Jayson Potts, Joel Ray, Gustavo Saposnik, Mukul Sharma, Eric E Smith, Sanjit Bhogal, Elisabeth Smitko, and M Patrice Lindsay (Senior and Corresponding Author), ?on behalf of the Heart and Stroke Foundation Canadian Stroke Best Practice Advisory Committees. In Lindsay MP, Gubitz G, Dowlatshahi D, Harrison E, and Smith EE (Editors).? Canadian Stroke Best Practice Recommendations 6th Edition: Secondary Stroke prevention during Pregnancy Consensus Statement, 2017; Ottawa, Ontario Canada: Heart and Stroke Foundation.?slot online มือถือ www.bigbadsportsblog.com

Comments

We invite comments, suggestions, and inquiries on the development and application of the Canadian Stroke Best Practice Recommendations.? Please forward comments to the Heart and Stroke Foundation’s Stroke Team at strokebestpractices@heartandstroke.ca.