Stroke In and After Pregnancy – Risk Factors and Preventive Measures
Though pregnancy is a time to enjoy, it can become a stressful phase for someone, increasing the chances of several ailments, with the risk of stroke being one of them. Stroke in and after pregnancy is shockingly on the rise. It’s common for women to brush off stroke symptoms as just another pregnancy woe, but it can turn out to be dangerous. Continue reading to learn how to recognise the symptoms of a stroke and why they occur during pregnancy so that you can make your pregnancy journey full-proof.
Is Stroke During or After Pregnancy Common?
While stroke isn’t common during pregnancy, the bodily change that goes on slightly increases the chances. Young women in their childbearing age have a lower risk of stroke. However, the hormonal changes brought about by pregnancy can make some women susceptible to blood clots. The risk also continues into the postpartum period, several weeks after delivery. The risk of stroke is higher in women with blood clotting problems, high blood pressure, heart disease, and autoimmune conditions.
What Are the Risk Factors for Stroke During or After Pregnancy?
The risk of stroke during and after pregnancy depends on a number of factors which we will discuss below. Here are some known stroke and pregnancy risks:
1. High Blood Pressure
Women who have had normal blood pressure before pregnancy can develop high blood pressure during pregnancy, so it’s not always the case that if you have had high blood pressure before pregnancy, then only you will have high blood pressure during pregnancy. Anyone can be susceptible to it. High blood pressure remains the leading cause of stroke in pregnant women and those who have given birth recently.
Preeclampsia is a condition characterised by dangerously high levels of blood pressure during pregnancy. It can cause headaches, vision problems, swelling in the face and hands, low birth weight, and even premature delivery. In its most severe form, it can cause seizures (eclampsia) and stroke.
3. Gestational Diabetes
Some women develop high blood sugar and gestational diabetes during pregnancy. It leads to high blood pressure and chances of heart disease or stroke further down the line.
4. Blood Clots
Pregnancy naturally increases the likelihood of blood clots which raises the chances of a stroke. Swelling in parts of the body, such as the legs, slows down the blood flow, and clotting is more likely to happen when blood doesn’t circulate well. During the third trimester, the body also produces a compound which helps with blood clotting to protect women from excessive bleeding during childbirth. This could also be one of the reasons for blood clotting.
What Are the Symptoms of Stroke During and After Pregnancy?
The symptoms are similar to any other stroke, whether it is a mini-stroke during pregnancy or a major one. Here are ten signs of a stroke during pregnancy:
1. Neurological Deficits
These are the most common signs of a stroke, such as loss of sensation, trouble speaking, trouble comprehending, loss of coordination and weakness on one side of the body. They may occur simultaneously and mean that either a stroke is imminent or is happening.
Intense headaches that feel different from the others and last longer are common when caused by cerebral venous thrombosis (CVT). It could also be accompanied by weakness, numbness or double vision. The thunderclap headache is another form of intense headache which needs immediate emergency care. If you have cerebral venous thrombosis (CVT), any signs like headache or blurry vision should not be ignored, and you must get emergency medical attention.
3. Blurred Vision
High blood pressure in women can affect the occipital lobe, which is located in the back of the brain. It is responsible for processing vision and can indicate a stroke before it happens.
Seizures are one of the first signs of a stroke. A brain injury caused by a stroke can trigger a seizure. It can be a symptom of haemorrhagic strokes or RPLS. They are both triggered by very high blood pressure that can occur in a high-risk pregnancy.
Dizziness is also an important symptom to look out for. When it is accompanied by blurry vision, vomiting, slurred speech or loss of balance, they are symptoms of a stroke and require immediate medical attention.
6. Feeling Lethargic
Bleeding or swelling inside the brain can also lead to the sudden onset of sleepiness or lethargy. These happen commonly in cases of high blood pressure, cerebral venous thrombosis (CVT), reversible posterior leukoencephalopathy syndrome (RPLS), and other forms of stroke during pregnancy.
7. Breathing Difficulty
Sometimes breathing difficulty is also accompanied by other symptoms of a stroke. However, it is also a common symptom of stress and anxiety. Frequent episodes of shortness of breath are a sign of a serious health problem and must not be ignored.
Different parts of the body might feel numb or have an unusual burning sensation during a stroke due to the compression of nerves. When numbness is associated with weakness in the limbs, drooping of the face, difficulty in speaking or confusion, it could be a stroke, and medical attention should be sought immediately.
9. General Weakness
While some might experience weakness in certain limbs or parts of the body, others might experience weakness in the full body. It could be accompanied by dizziness, breathing problem, and irregular heartbeat.
Hallucinations are when you begin to see or hear things that don’t exist or even feel sensations without an external stimulus. Hallucinations can sometimes be side effects of medications, but they can also be felt during a stroke.
How to Reduce the Risk of Stroke and Have a Healthy Pregnancy?
The effects of stroke during pregnancy can be just as dangerous for the baby as it is to you. Therefore, it’s important to reduce the risk as much as possible. Here are some tips to help:
1. Quit Smoking
Smoking constricts the veins and increases blood pressure hence significantly increasing the chances of a stroke. If you’re pregnant, do not smoke. If you are already in the habit, learn how to quit.
2. Keep Your Weight Within Healthy Limits
Although it’s normal to gain weight during pregnancy, maintaining a healthy weight helps better regulate blood sugar levels and blood pressure. Eat nutritious food and cut down on junk.
3. Eat Healthily
Include whole grains, healthy fats, nuts, fruits, and vegetables in your diet and cut down on processed foods and high salt intake. Keep your sugar intake small as well to maintain healthy blood pressure.
4. Exercise or Stay Physically Active
It is recommended that pregnant women get 30 minutes of moderate physical activity every day. If you cannot maintain an exercise schedule, compensate for it with some physical activity.
5. Work With Your Doctor
If you have concerns about high blood pressure or sugar, talk to your doctor about how to better manage your risk of a stroke. Schedule regular visits to have yourself monitored.
Having a stroke when you are pregnant is a serious medical emergency, and immediate help should be sought to minimise the damage. Call the emergency number if you notice any of the symptoms of a stroke.
1. Pregnancy and Stroke: Are You at Risk?; CDC; https://www.cdc.gov/stroke/pregnancy.htm
2. Pregnancy and Stroke; American Heart Association; https://www.goredforwomen.org/en/know-your-risk/pregnancy-and-maternal-health/pregnancy-and-common-heart-conditions/pregnancy-and-stroke
3. Horsager-Boehrer. R; Watch for stroke symptoms when pregnant; UTSouthwestern Medical Center; https://utswmed.org/medblog/stroke-pregnancy/ ;May 2015
4. Miller. EC, Leffert. L; Stroke in Pregnancy: A Focused Update; Anesth Analg.; PubMe Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035913/ ;April 2020
5. Grear. KE, Bushnell. CD; Stroke and Pregnancy: Clinical Presentation, Evaluation, Treatment, and Epidemiology; Clin Obstet Gynecol.; PubMed Central; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671374/; June 2013
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