Stroke therapy in pregnancy

Pearls
1. Evaluation is similar to nonpregant patients
2. Low dose ASA (80-150 mg) in second and third trimesters in high risk women is safe for mother and fetus
3. VKA's are dangerous especially 6-12 weeks due to embyopathy, fetal wastage and are dangerous in second and third trimesters due to neurodevelopmental problems. Postpartum is believed safe.
4. UFH and LMWH does not cross the placenta or enter breast milk and is believed safe for fetus, although it can cause bleeding at uteroplacental junction.
5. ASA and heparin can be used combined during pregnancy.