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Hemorrhagic Stroke Management in Pregnancy 

Hemorrhagic Stroke Management in Pregnancy
Chapter:
Hemorrhagic Stroke Management in Pregnancy
Author(s):

Aaron I. Loochtan

, Jodi Dodds

, and Cheryl D. Bushnell

DOI:
10.1093/med/9780190667351.003.0015
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date: 05 August 2020

Intracerebral hemorrhage (ICH) during pregnancy and the puerperuim is a rare but potentially devastating complication of pregnancy. It is a condition that requires emergent medical attention and inclusion of multiple medical and or surgical specialists. Accurate diagnosis based on clinical exam and supported by neuroimaging techniques is essential. Medical management is the mainstay in most cases including post-hemorrhage blood product consideration, reversal agents if on anti-coagulation, blood pressure control, cerebral edema management, and treatment of seizures. Circumstances also arise in which surgical intervention is needed. It is important to also discuss optimal timing of delivery. Postpartum care including close blood pressure control, deep vein thrombosis prophylaxis (DVT), and risk factor modification are important. Ethical situations sometimes arise and must also be considered with respect to the mother and child.

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