The incidence of stroke (also known as cerebrovascular accident or CVA) increases in pregnancy. In light of this known risk factor, the American Heart Association and American Stroke Association issued their first stroke-prevention guidelines that focus only on women’s unique risks. These guidelines were published this month in Stroke, the journal of the American Heart Association.
Among the recommendations:
- Pregnant women with chronic hypertension or a history of pregnancy-related hypertension should take aspirin to reduce the risk of preeclampsia.
- Preeclampsia is a risk factor for CVA later in life, and other risk factors in such women, such as smoking, obesity and hormonal medicines, should be treated early.
- Pregnant women with severe hypertension should receive antihypertensive medicines.
- Pregnant women with moderate hypertension should be considered for treatment with anti-hypertensive medications, depending on other risk factors.
- Suspicion of cerebral venous thrombosis (i.e., a blood clot in the brain), more common in women, should warrant routine blood studies, including complete blood count CBC), chemistry panel, and prothrombin time and activated partial thromboplastin time (PT/PTT).
A neurologist with the New England Journal of Medicine (NEJM), commenting on the guidelines, noted that these “recommendations will require diffusion into routine primary care practice.” What does that mean? It means that it will take awhile for doctors to get up to speed on these new, specific requirements. As a medical malpractice attorney, it is apparent to me that there is an unacceptable lag time between adoption of new practice standards and their implementation by rank-and-file physicians. This is a recurring theme in many medical negligence cases.
When a physician or nurse practitioner puts a patient at risk of an avoidable condition, and injury occurs, a claim for medical negligence may exist under Ohio law. Therefore, when a pregnant woman suffers a stroke, it would be important to know if the physician complied with the prevailing treatment guidelines.