Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy

 

The Heart & Stroke Canadian Stroke Best Practice Consensus Statement: Secondary Stroke Prevention during Pregnancy provides the first broad-based, stroke-specific guidance around stroke secondary stroke prevention in pregnancy in the world. Although stroke in pregnancy is relatively rare, stroke risk during or immediately after pregnancy can be increased and a tailored management approach is required. This is the first of a two-part series devoted to stroke in pregnancy; the second of which will focus on management of a woman who experiences an acute stroke while pregnant.

This consensus statement focuses on unique aspects of secondary stroke prevention in a woman with a prior history of stroke or transient ischemic attack who is, or is planning to become, pregnant.

As maternal health is vital for fetal wellbeing, management decisions should be based on both decisions that would be made if the patient wasn’t pregnant and decisions that would be made if the patient hadn’t had a stroke. Women with a prior history of stroke may require closer monitoring throughout pregnancy and immediately after birth.

While empirical research in this area is limited, this consensus document is based on the best available literature and guided by expert consensus by both stroke experts and maternal-fetal medicine experts.

The focus is on maternal and fetal health while minimizing risks of a recurrent stroke, through counselling, monitoring, and the safety of select pharmacotherapy. Issues addressed include:

  • management considerations for secondary stroke prevention
  • use of antithrombotics
  • blood pressure management
  • lipid management
  • diabetes care and management for specific ischemic stroke etiologies in pregnancy.

Revised Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke have also recently been published in the International Journal of Stroke and are part of the sixth edition of the Heart & Stroke Canadian Stroke Best Practice Recommendations. The writing group chairs were Richard H Swartz and Noor Ladhani.

Click here to download the consensus statement from the International Journal of Stroke website.

Click here to download the recently updated Canadian Stroke Best Practice Recommendations (CSBPR) for the Secondary Prevention of Stroke from the International Journal of Stroke website.

Click here to access the methodology on the CSPBR website.

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