Be careful out there. You really should expect your doctors to be more competent than this. which means your board of directors is failing at setting goals for the hospital and removing incompetence!
Pregnancy-associated strokes often go undetected despite typical symptoms
In a multicentre retrospective study, more than 1 in 4 pregnant or postpartum patients with acute stroke experienced a missed diagnostic opportunity, often despite having typical stroke presentations and recent medical encounters.
The findings, published in the journal Stroke, highlight a critical need for improved stroke recognition and timely neuroimaging -- particularly among obstetric and emergency clinicians -- to reduce diagnostic delays and improve outcomes in this high-risk population.
“Stroke prevention is vital,” said Eliza Miller, MD, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. “We must close diagnostic gaps to protect maternal health. Our findings show that early warning signs are often missed, especially by clinicians without neurology training, and that education across specialties is essential.”
The researchers conducted a retrospective study across 5 US comprehensive stroke centres, including 135 patients aged 18 to 50 years who were pregnant or within 1 year postpartum and had confirmed acute strokes -- including arterial ischemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, or cerebral venous thrombosis -- between 2012 and 2021. Each case was reviewed by vascular neurologists using the validated Safer Stroke-Dx tool to determine whether a missed diagnostic opportunity (MDO) occurred, and data on presenting symptoms, prior medical encounters, and contributing factors were collected.
The study found that 27% of patients experienced an MDO, most commonly due to failure to recognise stroke symptoms or omission of appropriate neuroimaging, despite nearly all having typical presentations.
Notably, 92% of patients with MDO had at least 1 documented medical encounter in the month preceding the stroke, primarily with obstetric or emergency medicine clinicians.
Haemorrhagic strokes were more common among patients with missed diagnoses, highlighting a critical need for enhanced clinician education and heightened vigilance for stroke in pregnant and postpartum populations to ensure timely recognition and treatment.
“Our analysis found that nearly half of patients who had seen a healthcare provider prior to stroke diagnosis were evaluated by obstetricians and approximately one third by emergency medicine clinicians,” said Miller. “This, to us, represents a knowledge gap across specialties and reveals an opportunity to expand clinician education to recognise early signs of maternal stroke.”
Reference: https://www.ahajournals.org/doi/10.1161/STROKEAHA.125.052995
SOURCE: University of Pittsburgh
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