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| Risks need weighing in thrombolysis of stroke in pregnancy |
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31 March 2006
Thrombolytic therapy of acute ischaemic stroke with rt-PA or urokinase can be safely performed in pregnant women, but there are important risks for the mother and fetus that should enter into the decision-making process, according to a new report.
Four of the patients were treated with rt-PA, usually given intravenously, and four patients received urokinase, given locally. The rt-PA was typically given within 3 hours of the stroke, while urokinase was given <6 hours to >2 weeks after the stroke.
One woman died from arterial dissection during angioplasty, while the others experienced no major complications. Minor complications typically involved haematomas and other haemorrhages. Among the seven surviving women, three underwent therapeutic abortions, two had miscarriages, and two had healthy deliveries.
"The results suggest that thrombolysis can be performed with good outcomes for the mother and, occasionally, with good outcomes for the baby as well," Dr Levine noted. Ultimately, "you have to weigh the risks of the stroke against the risks of the treatment."
Reference:
Neurology 2006; 66 (5): 768-770.
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