Perinatal and Intrauterine Stroke

Intrauterine Stroke

An intrauterine stroke is a stroke that affects a prior to birth. When a baby has an intrauterine stroke, the anxiety and uncertainty can be overwhelming for the expectant parents. In recent years, the ability of doctors to detect a stroke in a baby prior to birth has been improving, while scientific research on prevention and treatment has been moving forward.

 

Intrauterine Stroke

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Who is at Risk?
There are not usually obvious symptoms associated with intrauterine stroke, so it is important for expectant mothers to have good prenatal care and to seek urgent medical attention for health problems such as trauma, fevers and seizures.

Some pregnancies carry a higher than average possibility that the baby may experience a stroke prior to birth. More babies who experience a stroke prior to birth are born to mothers who have blood-clotting conditions. Many of these blood-clotting disorders can be identified with the use of blood tests that are performed when a blood clotting or bleeding problem is suspected.

Treatment of blood clotting disorders during pregnancy requires a complex decision making process. Similarly, management of a stroke that affects the baby prior to birth is not straightforward. Sometimes  medication can help improve the outcome,and in other situations the medical plan primarily involves close observation.

What are the Consequences for the Baby?
A stroke that occurs prior to the birth of a baby means that the baby has experienced damage to the developing brain. Given that the detection of a stroke prior to birth is only recently emerging, there were probably many instances of intrauterine stroke that were never recognized or picked up in years past.

There are a number of different possible outcomes that can result from an intrauterine stroke, and they may range from mild problems to more noticeable disabilities. Some babies who have a stroke before they are born might go on to experience seizures or cerebral palsy. Others may have weakness of one part of the body, such as the arm or leg, while some may display behavioral or learning problems.

The outcome depends on a number of factors, including which region of the brain was affected, the size of the stroke, and the developmental stage of the growing baby. Studies show that many children who have experienced a stroke prior to birth do not go on to have significant neurological problems in life. 

What Can You Do?
If you have a bleeding or blood-clotting problem, it is important to let your doctor know when you begin considering pregnancy or as soon as you find out that you are pregnant. Similarly, if you have suffered from recurrent miscarriages or if you have ever had blood clots, it is important to work with your health care team to determine whether you have a blood clotting or bleeding problem that you do not know about.

There also a few risk factors that can increase the risk of intrauterine stroke. These include maternal use of recreational drugs, such as cocaine, and severe maternal bleeding or trauma. 

Taking Care of Your Baby

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If you find out, either during your pregnancy or after your baby is born, that he might have had a stroke- you need to make sure that you have a good pediatrician for your child and possibly a pediatric neurologist as well. Detailed neurological assessment in infancy can identify problems early on to help make a diagnosis, answer questions and construct a valuable plan of action.

Maintaining close medical evaluation to establish and monitor the baby's neurological development is essential. Early therapy to help develop good balance and motor skills, as well as emotional and learning skills can optimize recovery. Early evaluation of vision, speech and hearing can assist with directing corrective measures to help offset the disadvantage of a disability. Medication for problems such as seizures can help prevent injury and will help promote the best seizure control for the long term.

A Word From Verywell

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If you have been told that your baby may have had a stroke, then you can get medical care for your baby to optimize recovery. Many children who are born with all types of handicaps go on to achieve more than they or their parents had imagined and far more than children born with handicaps could achieve in the past.

Further Reading:

Prenatal, perinatal and neonatal risk factors for perinatal arterial ischaemic stroke: a systematic review and meta-analysis, Li C, Miao JK, Xu Y, Hua YY, Ma Q, Zhou LL, Liu HJ, Chen QX, Eur J Neurol. 2017 Aug;24(8):1006-1015.

Your Baby's Health

Expectant mothers have a lot on their plates. Knowing how to handle and recognize even the most frightening scenarios can help.

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