Miller et al reported risk factors for stroke in a pregnant woman with preeclampsia. These can help to identify a patient who may benefit from more aggressive management. The authors are from Columbia University and Massachusetts General Hospital.
Patient selection: woman who is pregnant or post-partum, with a history of pre-eclampsia or eclampsia during the pregnancy
Risk factors for stroke from the multivariate analysis:
(1) severe pre-eclamosia or eclampsia (odds ratio 7.2)
(2) infection on admission (odds ratio 3.0)
(3) prothrombotic state (odds ratio 3.5)
(4) coagulopathy (odds ratio 3.1)
(5) chronic hypertension (odds ratio 3.2)
Additional factors to consider:
(1) antithrombotic therapy for prothrombotic state
(2) HELLP syndrome
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