Stroke While Pregnant: Associate Professor Deidre Anne De Silva Explains

While it may seem like an unusual topic to discuss, but pregnancy-associated strokes are also the most common cause of serious long-term disability after pregnancy. Yes, stroke can strike anyone, even pregnant mothers. For a better understanding of stroke while pregnant, Mamahood held an exclusive interview with Associate Professor Deidre Anne De Silva, Head and Senior Consultant, Department of Neurology, National Neuroscience Institute at Singapore General Hospital Campus. Associate Professor Deidre Anne De Silva, Head and Senior Consultant, Department of Neurology, National Neuroscience Institute at Singapore General Hospital Campus. Let's read on her sharing based on the questions asked by fellow parents below. Q1. Strokes are often related to lifestyle and eating habits but is stroke a genetic condition? For pregnant mothers who are going through a stroke, how will it affect both the mother and the baby? Associate Professor Deidre Anne: The majority of strokes are due to acquired risk factors and unhealthy lifestyle habits. A very small proportion have a genetic basis. Stroke in pregnancy is rare and the impact on the baby depends on the stage of pregnancy and the mother’s condition. In terms of the mother, stroke severity can vary and it depends on the extent of the brain damage and complications as a result of the brain damage. Q2. Different mothers will experience different kinds of strokes. Generally, can you describe in detail how a pregnant mother is going through a stroke? Associate Professor Deidre Anne: The distribution of underlying stroke causes differs in pregnancy with some unusual causes being more common such as stroke due to blockage of veins. Pre-eclampsia which is a condition in pregnancy associated with high blood pressure can also be a cause of stroke. The stroke may present with the common signs such as face drooping, arm weakness and speech difficulty, it may also cause severe headache, drowsiness, confusion, and vomiting. Q3. What are the precautions that pregnant mothers can take in order to prevent stroke - like changing diets, eating habits etc. Associate Professor Deidre Anne: Pregnant mothers should go for regular antenatal checkups. If found to have high blood pressure or diabetes, one should comply with the doctor’s instructions and medications so these are well controlled. And of course, one should not smoke. Q4. Acting F.A.S.T means better recovery in the long run. What are the obvious signs that mothers can teach their kids to spot people with stroke signs? Associate Professor Deidre Anne: Mothers can teach their children about the mnemonic F.A.S.T, which is the best way to spot the signs of stroke, and to know what to do if they or someone they are with has a stroke. F.A.S.T stands for: F - Face drooping A - Arm weakness S - Speech difficulty T - Time to call 995 As stroke is an extremely time-sensitive condition, everyone—even children—can play a part in spotting stroke symptoms and potentially saving a life. Q5. There is a rise in strokes about 32.3% in adults aged 19-29 years old. How (or why) does stroke incidence increase amongst the younger generation? Associate Professor Deidre Anne: This may be due to lifestyle factors such as an unhealthy diet, lack of exercise, obesity and smoking. In addition, some young adults may have risk factors including high blood pressure which are not well controlled. Q6. Our food plan is an obvious lifestyle that we need to change in order to live healthier and longer. How can a change in lifestyle can help prevent a stroke? Associate Professor Deidre Anne: A healthy diet has been proven to reduce the risk of stroke. This may be in part due to the prevention or management of risk factors such as high blood pressure, high cholesterol and diabetes. Q7. Mini-strokes have to be treated as emergencies like normal strokes. Are mini strokes a start of something worse to come? Associate Professor Deidre Anne: Mini-strokes, also known as Transient Ischemic Attacks (TIA) are actually a warning sign. While they have the same symptoms as an actual stroke, these symptoms resolve completely within a few minutes, as the blood flow is re-established in time before permanent damage occurs. However, this does not mean that everything is fine as they are often followed by an actual stroke. An individual who suffers from a TIA is at a high risk for a stroke occurring soon after. Therefore, even if the symptoms are improving or resolved, it is crucial that a TIA patient seek medical treatment. The same action of calling for an ambulance should be taken. Prompt medical attention allows early assessment for the cause and institution of treatment to reduce the risk of a subsequent stroke. Q8. Strokes and mini strokes can be recovered but how soon can adults expect to recover after their strokes? Associate Professor Deidre Anne: For mini-strokes or TIAs, there will be a complete resolution in a few minutes. For a stroke, there are many factors that influence how long it takes to recover including the extent of brain damage if early treatment was received amongst others. Most stroke survivors will have some permanent residual effects from the stroke, the extent of which varies. There will usually be recovery for up to a few months after a stroke occurs. Q9. How long does pregnant mothers need to do physical or occupational therapy in order to recover faster? What are the treatments they will receive? Associate Professor Deidre Anne: For this question, there is no specific distinction for pregnant mothers. For stroke patients in general, the duration of physical or occupational therapy varies on an individual basis. Factors that may influence the duration include the extent of brain damage, the physical functions affected including strength, coordination and sensation, cognitive impact affecting thinking and understanding and if there are communication difficulties related to stroke. Q10. Do pregnant mothers need to go to emotional therapy to improve their mood and lead to faster recovery from their stroke? Associate Professor Deidre Anne: Similar to question 9, there is no specific distinction for pregnant mothers. Mood issues are stroke are common and this may be managed with counselling, peer support, and in some instances medications. Q11. Let's say a pregnant mother was diagnosed with a stroke and then she recovered. Will it affect her next pregnancy and is there a high chance for her to get another stroke? Associate Professor Deidre Anne: It depends on the cause. In instances where the cause is recurring in pregnancy, it will likely increase the risk of stroke in a subsequent pregnancy. In some, the risk may be similar whether the patient is pregnant or not. Q12. Recovery will take long periods of time. Does a patient need to know what part of the brain does the stroke affects? Associate Professor Deidre Anne: I often explain to my patients which parts of the brain are affected so they relate the brain damage and the stroke impairments they are facing. In fact, I usually show them their brain scans so they have a better understanding of their condition. We hope you have benefited from this sharing by Associate Professor Deidre Anne De Silva. Do share this article with other mummies who may be keen to learn more about this topic in their pregnancy journey. For more insightful stories, stay tuned to Mamahood Story!

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