Acute Stroke at Term Pregnancy: What Should Happen Before the Epidural?

Document Type

Article

Publication Date

9-20-2023

Publication Title

Cureus

Abstract

Acute stroke is a time-sensitive medical diagnosis, and current standardized management algorithms do not specifically streamline care for pregnant patients with these symptoms. Here, we discuss the management of a 29-year-old parturient with a history of systemic lupus erythematosus (SLE) who presented with stroke-like symptoms. We discuss strategies to improve care by incorporating formal neurological and ophthalmologic evaluations prior to referral for neuraxial intervention, particularly in light of the developing concerns among ophthalmologists that retinal transient ischemic attacks (TIAs) and visual symptoms should be treated with the same acuity as cerebral TIAs and strokes. We propose an integrated stroke algorithm in the pregnant population with consideration for specific ophthalmologic evaluation. In the present case, labor induction and epidural placement were successfully performed once a more optimized workup was completed.

Volume

15

Issue

9

First Page

e45613

DOI

10.7759/cureus.45613

ISSN

2168-8184

PubMed ID

37868405

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