Stroke during pregnancy and pre-eclampsia

PURPOSE OF REVIEW: Stroke is a life-threatening condition whose frequency is increased during pregnancy, in particular in the two first weeks of the puerperium. Pre-eclampsia/eclampsia is a disorder that enhances this risk. The purpose of this review is to summarize existing data regarding the association, diagnosis as well as management for stroke in pre-eclampsia or eclampsia. RECENT FINDINGS: In about one third of stroke cases during pregnancy or puerperium, pre-eclampsia or eclampsia is concomitantly diagnosed. In these women, hemorrhagic stroke is more common than ischemic stroke, probably as a result of severe hypertension. Clinical presentation may vary but severe headache is the most common symptom. Neuroimaging techniques are warranted to identify affected cases. Prevention is based on blood pressure adjustment and thromboprophylaxis. SUMMARY: The risk of stroke should be taken into consideration in women with a diagnosis of pre-eclampsia or eclampsia. In particular, women with neurologic symptoms should be promptly evaluated, blood pressure should be adjusted and thromboprophylaxis should be started.