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Stroke in Pregnancy
This article will review current information about the epidemiology, risk factors, pathophysiology, management, and outcomes of conditions associated with maternal stroke.Recent FindingsPregnancy confers a substantially increased risk of stroke in women. The period of highest risk of stroke is the peripartum and 6-week post-partum period, coinciding with the highest risk for hypertensive disorders of pregnancy and peak gestational hypercoagulability. Physiological changes of pregnancy, including hypercoagulable states, venous stasis, and hemodynamic changes, are significant contributors to maternal stroke. However, hyperte...
Source: Current Obstetrics and Gynecology Reports - February 22, 2023 Category: OBGYN Source Type: research

Prevention and Management of Stroke in Obstetrics and Gynecology
The objective of this review is to provide an evidence-based summary of stroke incidence, risk factors, prevention, and treatment of stroke in pregnancy. The impact of postpartum contraceptive use can on stroke risk is summarized.
Source: Clinical Obstetrics and Gynecology - April 26, 2018 Category: OBGYN Tags: The Prevention and Management of Thrombosis in Obstetrics and Gynecology Source Type: research

Stroke in Pregnancy
Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6  weeks postpartum. Hypertensive disorders of pregnancy and gestational hypercoagulability are important contributors to obstetric stroke. Preeclampsia and eclampsia confer risk for future cardiovascular disease. Hemorrhagic stroke is the most common type of obstetric stroke. Ischemic stroke can res ult from cardiomyopathy, paradoxical embolism, posterior reversible encephalopathy, reversible cerebral vasoconstriction syndrome, and dissections. Cerebral venous sinus thrombosis is a frequent complication of pregnancy.
Source: Obstetrics and Gynecology Clinics - February 9, 2021 Category: OBGYN Authors: Erica C. Camargo, Aneesh B. Singhal Source Type: research

Acute Management of Ischemic Stroke During Pregnancy.
Abstract Acute stroke in pregnancy can be devastating. Although neurologists will at some point be involved in the management, most of these patients are likely to first be evaluated by an obstetric care provider. It is, therefore, important for obstetric care providers to have an understanding of the presentation and management of stroke, particularly in the initial period when the window of opportunity for therapy is critical. Once suspected, a head computed tomography (CT) without contrast media should be performed without delay to rule out a hemorrhagic component. Patients presenting within 4.5 hours of sympto...
Source: Obstetrics and Gynecology - April 4, 2019 Category: OBGYN Authors: Pacheco LD, Hankins GDV, Saad AF, Saade GR Tags: Obstet Gynecol Source Type: research

Diagnostic of rare form of acute stroke (venous stroke) in early postpartum period
Introduction: Venous stroke (VS) is a rare form of acute ischemic stroke as a thrombosis of Trolard vein (the frequency 0.1% to 3 –5%) occurs when the outflow of blood from the superficial cortical veins of the brain along the large anastomotic vein of Trolard and the small anastomotic vein of Labbe in turn, flow into the large vein of Gallen, which collects blood from the deep cerebral veins and falls into a straight sinus. Verification of VS is difficult due to the following features: the defeat of the parieto-occipital region gives meagre focal neurologic symptoms and more pronounced cerebral symptoms.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - February 19, 2019 Category: OBGYN Authors: Nataliia Chemer, Nadiia Ruda, Andrii Tkachenko Tags: Movies Case Reports 2 – PPH, Puerperium and Neurology Source Type: research

Both thromboembolic stroke and cerebral venous thrombosis resulting from Ovarian Hyperstimulation Syndrome (OHSS).
Authors: Zhang FL, Fu LL, Yang Y PMID: 26467967 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology - February 19, 2016 Category: OBGYN Tags: J Obstet Gynaecol Source Type: research

Hormone therapy in postmenopausal women associated with risk of stroke and venous thromboembolism: a population-based cohort study in Taiwan
Conclusions: In postmenopausal Taiwanese women, HT may be associated with an increased risk of cardiovascular disease. Although the women in our population receiving HT were near menopausal age, their risk of cardiovascular disease was still higher than in the non-HT group.
Source: Menopause - January 29, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study
Conclusions:The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment. Objective: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. Methods: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observat...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Women's Health Initiative clinical trials: potential interactive effect of calcium and vitamin D supplementation with hormonal therapy on cardiovascular disease
Conclusions: CaD did not consistently modify the effect of CEE therapy or CEE + MPA therapy on CVD events. However, the increased risk of stroke due to CEE therapy appears to be mitigated by CaD supplementation. In contrast, CaD supplementation did not influence the risk of stroke due to CEE + MPA.
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Managing menopause.
Authors: Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W, Menopause and Osteoporosis Working Group, Fortier M, Reid R, Abramson BL, Blake J, Desindes S, Dodin S, Graves L, Guthrie B, Khan A, Johnston S, Rowe T, Sodhi N, Wilks P, Wolfman W Abstract OBJECTIVE: To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality. OUTCOMES: Lifestyle...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - December 2, 2014 Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research

Lessons Learned From the Women's Health Initiative Trials of Menopausal Hormone Therapy.
Abstract We re-evaluate the Women's Health Initiative findings and their implications for clinical practice. Menopausal hormone therapy (HT) was effective for relief of vasomotor symptoms, and the risk of coronary heart disease (CHD) tended to be reduced in women close to menopause compared with the increased risk in women more distant from menopause. In recently menopausal women, short-term absolute risks of stroke and venous thromboembolism were small. Estrogen plus progestin therapy, but not estrogen therapy, increased the risk of breast cancer with a suggestion of greater risk when initiated close to the menop...
Source: Obstetrics and Gynecology - January 1, 2013 Category: OBGYN Authors: Rossouw JE, Manson JE, Kaunitz AM, Anderson GL Tags: Obstet Gynecol Source Type: research

Estrogen alone and health outcomes in black women by African ancestry: a secondary analyses of a randomized controlled trial
Conclusions: In black postmenopausal women with prior hysterectomy, estrogen alone significantly reduced breast cancer incidence with no adverse influence on CHD, venous thromboembolism, or all-cause mortality. Favorable estrogen-alone global index effects in younger black women warrant further study.
Source: Menopause - January 28, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Drospirenone‐containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review
BackgroundPrevious studies have provided conflicting results regarding the effect of drospirenone‐containing oral contraceptive pills (OCPs) on the risk of venous and arterial thrombosis. ObjectivesTo conduct a systematic review to assess the risk of venous thromboembolism (VTE), myocardial infarction (MI), and stroke in individuals taking drospirenone‐containing OCPs. Search strategyWe systematically searched CINAHL, the Cochrane Library, Dissertation & Abstracts, EMBASE, HealthStar, Medline, and the Science Citation Index from inception to November 2012. Selection criteriaWe included all case reports, observation...
Source: BJOG: An International Journal of Obstetrics and Gynaecology - March 26, 2013 Category: OBGYN Authors: CQ Wu, SM Grandi, KB Filion, HA Abenhaim, L Joseph, MJ Eisenberg Tags: Systematic Review Source Type: research

Drospirenone-containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review.
CONCLUSIONS: Our systematic review suggests that drospirenone-containing OCP use is associated with a higher risk for VTE than both no OCP use and levonorgestrel-containing OCP use. PMID: 23530659 [PubMed - in process]
Source: BJOG : An International Journal of Obstetrics and Gynaecology - May 25, 2013 Category: OBGYN Authors: Wu C, Grandi S, Filion K, Abenhaim H, Joseph L, Eisenberg M Tags: BJOG Source Type: research

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