ISC 2026 | Guidance for recognizing stroke during pregnancy and postpartum
Andrea Shields, MD, MS, UConn Health, Farmington, CT, gives guidance for recognizing stroke in pregnant and postpartum individuals. Dr Shields highlights that headache can be a critical warning symptom, and she emphasizes the importance of careful blood pressure assessment, risk factor evaluation, and pregnancy history to reduce missed or delayed diagnoses. This interview took place at the 2026 International Stroke Congress (ISC), held in New Orleans, LA.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
Yeah, I think for neurologists and for other care professionals, it’s really important to understand that the vast majority of patients who in pregnancy or postpartum who present with stroke, present with common symptoms such as headache. Headache is a very common symptom in pregnancy, but it also can be, of course, the red flag, that suggests or signifies stroke. We did a recent study that we published in Stroke that showed that on average a pregnant or postpartum patient who’s diagnosed with a stroke has 2...
Yeah, I think for neurologists and for other care professionals, it’s really important to understand that the vast majority of patients who in pregnancy or postpartum who present with stroke, present with common symptoms such as headache. Headache is a very common symptom in pregnancy, but it also can be, of course, the red flag, that suggests or signifies stroke. We did a recent study that we published in Stroke that showed that on average a pregnant or postpartum patient who’s diagnosed with a stroke has 2.5 visits either to urgent care or to their doctor before they actually get diagnosed with a completed stroke. Of those visits, there’s about half the time there is missed, stroke risk factors. So we want to just make sure healthcare professionals are really paying attention to pregnant or postpartum women if they’re showing up with complaints of a headache, look at their blood pressure. If their blood pressures are mild range or greater, you really have to dig in and see is this acute new onset hypertension versus pre-existing hypertension. If it’s acute new onset, that is a big red flag that this headache might represent something other than common things like tension or migraine and needs to be explored further. Of course, the other questions that we typically ask about headache, the quality, the character, other associated neurologic symptoms. Current medications, past medications, history of stroke, family history, and then in general, patients who are up to a year postpartum, we need to ask them about their pregnancy history to know that they’re in that risk category. So patients who develop peripartum cardiomyopathy, again, those symptoms may not always be easily recognizable at first, and so patients who are presenting with headache and some fatigue, shortness of breath, and are within that one year of delivery, we should vet them more closely for things like pericardiomyopathy, which is again a fivefold increased risk for stroke.
This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.
Read more...
