title: Thrombolysis for Ischemic Stroke during Pregnancy: A Case Report and Review of the Literature.
abstract: OBJECTIVE
  Our knowledge of the safety of thrombolytic therapy in pregnancy stems from individual case reports and series. We report the successful use of intravenous alteplase (tissue plasminogen activator; tPA) thrombolysis in a pregnant woman with acute cardioembolic stroke presumed to be paradoxical embolism through a patent foramen ovale.
  
  
  METHODS
  A literature review found several case reports and case series of pregnant patients treated with either intravenous or intra-arterial tPA for acute ischemic stroke.
  
  
  RESULTS
  A literature review yielded 10 cases of intravenous tPA administration and 5 cases of intra-arterial tPA. In total, there were 3 cases of asymptomatic intracerebral hemorrhage and 1 case of maternal and fetal death.
  
  
  CONCLUSIONS
  Our patient improved clinically with no residual deficits. There was no evidence of placental or fetal injury following administration of tPA on follow-up obstetrical evaluations.
authors: Northwell Health, Great Neck, New York.
authors: Steven
authors: S
authors: Tversky
authors: Northwell Health, Great Neck, New York.
authors: Richard B
authors: RB
authors: Libman
authors: Northwell Health, Great Neck, New York.
authors: Marina L
authors: ML
authors: Reppucci
authors: Northwell Health, Great Neck, New York.
authors: Andrea M
authors: AM
authors: Tufano
authors: Northwell Health, Great Neck, New York. Electronic address: JKatz2@Northwell.edu.
authors: Jeffrey M
authors: JM
authors: Katz
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D017809:Fatal Outcome; D005260:Female; D005313:Fetal Death; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D063130:Maternal Death; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Ischemic stroke; alteplase; pregnancy; tPA; thrombolysis