Intravenous tissue plasminogen activator for ischemic stroke in early pregnancy dosed by actual body weight

SAGE Open Medical Case Reports
Gary D PeksaTeresa Davis

Abstract

Few published reports highlight intravenous tissue plasminogen activator use during the first trimester of pregnancy and provide outcomes for mother and fetus. Little guidance is available regarding body weight dosing of intravenous tissue plasminogen activator during pregnancy. Here, we present a patient who received intravenous tissue plasminogen activator in the emergency department during her first trimester of pregnancy for the treatment of an acute ischemic stroke. Outcomes are presented for mother and fetus, as well as discussion about the dosing weight utilized for the intravenous tissue plasminogen activator dose calculation. A 35-year-old, Gravida 7 Para 6, presented to the emergency department at 9 weeks gestation with acute stroke symptoms. Her initial National Institutes of Health Stroke Scale was 7. Imaging revealed a hyperdense right middle cerebral artery sign. Intravenous tissue plasminogen activator was administered 57 min after her arrival and based on her actual body weight during pregnancy. Post tissue plasminogen activator imaging revealed recanalization of the vessel and the patient's National Institutes of Health Stroke Scale was 0. The patient progressed to delivery of a healthy female infant. The patie...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
May 16, 2002·Cerebrovascular Diseases·Michael Dapprich, Wolfgang Boessenecker
Mar 15, 2006·Neurology·A MurugappanS R Levine
Aug 28, 2013·Neurologia Medico-chirurgica·Teruyuki Hirano
Oct 11, 2015·Seminars in Perinatology·Maisa FeghaliSteve Caritis
Dec 29, 2015·American Journal of Obstetrics and Gynecology·Lisa R LeffertLee H Schwamm

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