Stroke During Pregnancy


Pregnancy is an exciting time, full of excitement, anticipation and even a little bit of apprehension about the brand new arrival. Most feelings and attention throughout pregnancy focus on the wellbeing of the baby. But for some women, a stroke during pregnancy can seriously complicate an otherwise joyful occasion. Pregnancy risks should be viewed, not with fear, but instead with a focus on preparation.

Knowing what to do- even in the worst of all possible circumstances- is your best way to get ready for taking care of your health and your baby’s health for years to come.

Who is at Risk of Stroke in Pregnancy?

Pregnancy produces obvious transformations in the mother's body. Some unusual physiological changes in the mother's body can include alterations in blood-clotting function.  This is often described as a hypercoagulable state, which means an increased tendency to develop dangerous blood clots, such as strokes, throughout the body. This can be a problem for women who have high blood pressure, heart disease, obesity, lupus, blood clotting disorders, sickle cell anemia or advanced age. There is also some controversy about whether women who experience migraines are at a higher risk of stroke during pregnancy.

The treatment for medical conditions such as blood clotting disorders, lupus, heart disease, high blood pressure and migraines must be customized during pregnancy.

Thus, if you have one of these medical conditions, you need to make sure that both your obstetrician and the doctor who regularly manages your illness are aware of your pregnancy and the particulars of your medical condition. During pregnancy, some medication adjustments may be needed and careful medical monitoring may be necessary before, during and shortly after pregnancy.


An uncommon situation that may occur late in pregnancy is an emergency called pre-eclampsia. Characterized by severe high blood pressure, pre-eclampsia increases the risk of stroke during pregnancy, delivery or shortly after delivery of the baby.


How Common is a Stroke During Pregnancy?

The incidence of a stroke during pregnancy is about 35 per 100,000 pregnancies. This is a very low number, and therefore it is not necessary for you to worry about having a stroke if you have been healthy and have never been diagnosed with any of the illnesses that are known to increase the risk of stroke during pregnancy.

When Should You Worry?

Neurological symptoms during pregnancy may turn out to be harmless. However, it is always better to be safe than sorry, because stroke management is very complex during pregnancy and it has been well established that treatment is most effective when it is administered right away. If you experience confusion, slurred speech, changes in vision, weakness of the arm or leg on one side of the body, tingling or numbness of the face or body, weakness or drooping of the face, lips, mouth or eyelids, you should get medical attention right away.

The best medical attention in such a situation is an in-person emergency evaluation, not a phone call to your doctor.  Changes to the face, eyes or body during a stroke are impossible for a doctor or medical answering service to accurately assess over the phone, and must be done in person.

How to Cope with a Stroke During Pregnancy.

If you experience a stroke during pregnancy, you may have to adjust to a new disability and undergo rehabilitation while continuing to take care of your pregnancy and learning how to care for your baby. This situation presents a number of huge challenges all at once. Take full advantage of all of your available support systems, including social work, disability services and benefits and rehabilitation therapy as you recover. You may need extra planning and medical care for future pregnancies. And with time and good medical care, you are likely to regain some your abilities.


Migraine, cardiovascular disease, and stroke during pregnancy: Systematic review of the literature, Wabnitz A, Bushnell C, Cephaligia, October 2014

A review of stroke and pregnancy: incidence, management and prevention.Moatti Z, Gupta M, Yadava R, Thamban S , European Journal of  Obstetrics, Gynecology and Reproductive Biology, October 2014

Incidence and risk factors for stroke in pregnancy and the puerperium, James AH, Bushnell CD, Jamison MG, Myers ER, Obstetrics and Gynecology, September 2005

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