Fatal Stroke in Pregnancy and the Puerperium

Stroke. 2018 Dec;49(12):3050-3053. doi: 10.1161/STROKEAHA.118.023274.

Abstract

Background and Purpose- Fatal stroke during pregnancy and the puerperium is rare. Pregnancy-related hypertension and vascular abnormalities underlie significant proportions of pregnancy-related stroke, but up to one-quarter are of no known cause. Methods- Case series of fatal pregnancy-related stroke. All cases where the cause of death was attributed to stroke during pregnancy/postpartum were retrieved from the National Coronial Information System database (January 1, 2009 to December 31, 2016). Results- Fourteen fatal strokes were identified, all hemorrhagic in origin. Underlying causes included pregnancy-related hypertension, rupture of vascular malformations, vasculitis, and cardiomyopathy. Conclusions- Fatal pregnancy-related stroke occurred secondary to hemorrhages of heterogeneous causes, including pregnancy-related hypertension and previously undiagnosed risk factors.

Keywords: cause of death; hemorrhagic; hypertension; postpartum; pregnancy; risk factors; stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aneurysm, Ruptured
  • Australia
  • Cardiomyopathies
  • Cause of Death
  • Female
  • HELLP Syndrome
  • Humans
  • Hypertension, Pregnancy-Induced
  • Intracranial Aneurysm
  • Intracranial Hemorrhages
  • Posterior Leukoencephalopathy Syndrome
  • Pregnancy
  • Pregnancy Complications, Cardiovascular*
  • Puerperal Disorders*
  • Stroke*
  • Subarachnoid Hemorrhage
  • Vasculitis