Pregnancy After Stroke: What Are The Risks? | Nervous System Disorders and Diseases medical answers | Body & Health Conditions center

Overview

Although becoming pregnant after suffering a stroke does have its obstacles that you'll need to overcome, it is possible to still have healthy children after experiencing such as condition.

There are adjustments that need to be made to any medications the potential mother may be using and the patient would also need to be monitored closely and frequently by her neurologist and an obstetrician who specializes in high-risk pregnancies.

Medications

The following medications for applicable chronic conditions that are associated with strokes need to be made:

Blood pressure medication needs to be changed to a drug such as methyldopa as it is one of the only anti-hypertensive medications that are safe for exposure to the fetus without causing any birth defects.
Patients who are using anticonvulsant medications may need to have these drugs reviewed to make sure they are safe to be used during the pregnancy as some may cause neural tube defects in the developing fetus.
Those individuals who had a stroke due to obstruction of a blood vessel to the brain by a thrombus (clot) will have to use anticoagulants (blood thinners) such as heparin for the duration of the pregnancy. The reason for this is because pregnancy itself increases the clotting ability (coagulability) of blood which then increases the chances of a blood clot developing.
Diabetic patients will be monitored during antenatal visits to their doctors to make sure that the pregnancy itself is not stimulating increased glucose production or release into the bloodstream. The diabetic medications used by the patient usually stays the same but the dosages may just need adjusting where applicable.

Considerations

It's important to discuss the possibility of becoming pregnant after having a stroke as the decision will also depend on the severity of the condition as well as what the cause of the problem was. The rule of thumb is that if the benefits outweigh the risks then one can go ahead and become pregnant.

The functional ability of the patient will also play a role in what her ultimate decision is at the end of the day. In most cases, there is a partner involved so they will have to understand and accept that their involvement will be high. This is applicable not only to the care of the child but the care of the mother to help out when she struggles with certain activities.

Modifiable risk factors such as smoking cigarettes, obesity, and a sedentary lifestyle will also need to be addressed as these factors also increase the risk of a stroke.

Birth control

Another important topic for discussion is what forms of contraception will be the safest to use. Although this doesn't have anything to do with the changes that need to be considered for becoming pregnant, the decision for what contraception needs to be used before making the decision to become pregnant or after the baby is born is important.

The barrier methods such as male and female condoms are the safest options, especially for those patients who don't want to use hormonal contraception as this increases the risk of blood clot formation. Although this is true, estrogen-free contraception in the form of certain intra-uterine devices (IUDs) and implantable devices may be considered.