1425 - Life after Stroke: Planning for Pregnancy

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Corresponding Author(s)

BB

Brittany Blitstein, BS

Medical Student
VCOM- Virginia
Blacksburg, Virginia, United States

Presenting Author(s)

AA

Amy Auld, BS

Pre-Medical Student
NC State University
Brown Summit, North Carolina, United States
LN

Lillian Nguyen, BS

Medical Student
Wright State University - Boonshoft SOM
Charlotte, North Carolina, United States

Submitter(s)

BB

Brittany Blitstein, BS

VCOM- Virginia
Blacksburg, Virginia, United States

Objectives: This narrative review considers the management of secondary stroke risk factors in the setting of patients considering pregnancy. Outlining current guidelines from a pre-pregnancy perspective can contribute an accessible protocol managing a patient's risk factors and post-stroke symptoms. This review can be utilized by providers when addressing individualized patient care plans.

Design: This narrative review considers the management of secondary stroke risk factors in the setting of patients considering pregnancy. Outlining current guidelines from a pre-pregnancy perspective can contribute an accessible protocol managing a patient's risk factors and post-stroke symptoms. This review can be utilized by providers when addressing individualized patient care plans.

Results: Research on managing post-stroke rehabilitation in populations planning pregnancy can be grouped thematically into treatment regimens: anticoagulation, hypertension, and lifestyle factors. Establishing patients on non-teratogenic anticoagulation and hypertensive medications with the treatment target of < 130/80 mmHg can reduce the risk of stroke complications during pregnancy. Management of post-stroke neuralgias and physical deficits can promote improved functional activity for patients. Neuralgia treatments, such as gabapentin, are considered detrimental due to concerns for folic acid levels; this medication is not recommended in pregnancy. Treatments for spasticity, such as tizanidine, baclofen, and botulinum toxin injections, are not well studied in pregnancy and are US FDA pregnancy category C. Oral baclofen carries risks for temporary neonatal symptoms of withdrawal. However, these symptoms have not been reported for intrathecal pump methods of baclofen delivery. PT/OT is also recommended for improving strength in patients with post-stroke sequelae.

Conclusions: Pregnant patients carry an increased risk of stroke three times that of nonpregnant patients of similar age. Management with pregnancy-safe medications can establish a decreased risk of stroke recurrence and mitigate the inherent pregnancy-associated stroke risk. This allows providers to confidently guide and establish successful rehabilitation during pregnancy.