Medically Reviewed by Timothy L. Hagen, DO

New guidelines on managing stroke risk in pregnant women have sparked a minor controversy between the American Heart Association and the Society for Maternal-Fetal Medicine.  One very positive outcome of this skirmish is greater awareness among women about their unique risks and symptoms for stroke.

FIRST, THE BASICS

A “heart attack” is a blockage of blood flowing through the heart in order to be reoxygenated. In much the same way, a stroke is a “brain attack” caused by a loss of blood flow to the brain.  A stroke can also be cause by bleeding in the brain.

Major risks leading to stroke in women are high blood pressure, birth control pills, migraine headaches with auras, diabetes, depression, carotid artery disease and atrial fibrillation.

Two pregnancy complications can lead to stroke:  1) Preeclampsia, which is accompanied by a rise in blood pressure, and 2) post-delivery bleeding.

Women are the victims of 6 out of 10 strokes.  Black and Hispanic women have a greater risk than Caucasian women.  And North Carolina and South Carolina comprise the so-called “buckle of the stroke belt” where our risk of stroke – thanks in part to smoking and salty fried food – is twice as much as elsewhere in the country.

NOW THE GUIDELINE CONTROVERSY

In early 2014, the American Heart Association released its new guidelines for treating stroke risk among pregnant women.  Shortly afterwards, the Maternal-Fetal professional group expressed concern that the AHA guidelines were not based on data as new as that used by another professional organization – American College of Obstetricians & Gynecologists — in drafting its guidelines released in last 2013.

According to the media debate, the two sets of guidelines differ on stroke criteria for 1) patients with a complication known as preeclampsia, 2) the use of low-dose aspirin to prevent preeclampsia, and 3) the treatment of hypertension in pregnant women.

“It’s not unusual for media coverage of new studies and research to leave the public confused best or (at worst) misled,” says McLeod Neurologist, Timothy Hagen, DO.  “Your personal physician is always the best place to find the most recent, most accurate information and place it in context for your unique situation.”

In the meantime, if you think someone is having a stroke it is important to be FAST!

F –  Face: Ask the person to smile.  Does one side of their face drop?

A –  Arms: Ask the person to raise both arms.  Does one arm drift?

S –  Speech: Is the person’s speech slurred or strange?

T –  Time: Act Fast.  Call 911 immediately!!

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Sources include: McLeod Health, American Heart Association, National Stroke Association, Healthy Woman, Go Red for Women, Circulation, Society for Material-Fetal Medicine.