European Stroke Organisation guidelines on stroke in women : Management of menopause, pregnancy and postpartum
(2022) In European Stroke Journal 7(2).- Abstract
Pregnancy, postpartum and menopause are regarded as periods women are more vulnerable to ischaemic events. There are conflicting results regarding stroke risk and hormone replacement therapy (HRT) during menopause. Stroke in pregnancy is generally increasing with serious consequences for mother and child; therefore, recommendations for acute treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) are needed. The aim of this guideline is to support and guide clinicians in treatment decisions in stroke in women. Following the “Grading of Recommendations and Assessment, Development and Evaluation (GRADE)” approach, the guidelines were developed according to the European Stroke Organisation (ESO) Standard Operating... (More)
Pregnancy, postpartum and menopause are regarded as periods women are more vulnerable to ischaemic events. There are conflicting results regarding stroke risk and hormone replacement therapy (HRT) during menopause. Stroke in pregnancy is generally increasing with serious consequences for mother and child; therefore, recommendations for acute treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) are needed. The aim of this guideline is to support and guide clinicians in treatment decisions in stroke in women. Following the “Grading of Recommendations and Assessment, Development and Evaluation (GRADE)” approach, the guidelines were developed according to the European Stroke Organisation (ESO) Standard Operating Procedure. Systematic reviews and metanalyses were performed. Based on available evidence, recommendations were provided. Where there was a lack of evidence, an expert consensus statement was given. Low quality of evidence was found to suggest against the use of HRT to reduce the risk of stroke (ischaemic and haemorrhagic) in postmenopausal women. No data was available on the outcome of women with stroke when treated with HRT. No sufficient evidence was found to provide recommendations for treatment with IVT or MT during pregnancy, postpartum and menstruation. The majority of members suggested that pregnant women can be treated with IVT after assessing the benefit/risk profile on an individual basis, all members suggested treatment with IVT during postpartum and menstruation. All members suggested treatment with MT during pregnancy. The guidelines highlight the need to identify evidence for stroke prevention and acute treatment in women in more vulnerable periods of their lifetime to generate reliable data for future guidelines.
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- guidelines, menopause, postpartum, pregnancy, Stroke, women
- in
- European Stroke Journal
- volume
- 7
- issue
- 2
- publisher
- SAGE Publications
- external identifiers
-
- scopus:85127816834
- pmid:35647308
- ISSN
- 2396-9873
- DOI
- 10.1177/23969873221078696
- project
- Stroke hos kvinnor
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © European Stroke Organisation 2022.
- id
- 619370f2-fdeb-42e6-aaeb-a0c96c16a13a
- date added to LUP
- 2022-05-09 15:08:54
- date last changed
- 2024-06-10 01:13:09
@article{619370f2-fdeb-42e6-aaeb-a0c96c16a13a,
abstract = {{<p>Pregnancy, postpartum and menopause are regarded as periods women are more vulnerable to ischaemic events. There are conflicting results regarding stroke risk and hormone replacement therapy (HRT) during menopause. Stroke in pregnancy is generally increasing with serious consequences for mother and child; therefore, recommendations for acute treatment with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) are needed. The aim of this guideline is to support and guide clinicians in treatment decisions in stroke in women. Following the “Grading of Recommendations and Assessment, Development and Evaluation (GRADE)” approach, the guidelines were developed according to the European Stroke Organisation (ESO) Standard Operating Procedure. Systematic reviews and metanalyses were performed. Based on available evidence, recommendations were provided. Where there was a lack of evidence, an expert consensus statement was given. Low quality of evidence was found to suggest against the use of HRT to reduce the risk of stroke (ischaemic and haemorrhagic) in postmenopausal women. No data was available on the outcome of women with stroke when treated with HRT. No sufficient evidence was found to provide recommendations for treatment with IVT or MT during pregnancy, postpartum and menstruation. The majority of members suggested that pregnant women can be treated with IVT after assessing the benefit/risk profile on an individual basis, all members suggested treatment with IVT during postpartum and menstruation. All members suggested treatment with MT during pregnancy. The guidelines highlight the need to identify evidence for stroke prevention and acute treatment in women in more vulnerable periods of their lifetime to generate reliable data for future guidelines.</p>}},
author = {{Kremer, Christine and Gdovinova, Zuzana and Bejot, Yannick and Heldner, Mirjam R. and Zuurbier, Susanna and Walter, Silke and Lal, Avtar and Epple, Corina and Lorenzano, Svetlana and Mono, Marie Luise and Karapanayiotides, Theodore and Krishnan, Kailash and Jovanovic, Dejana and Dawson, Jesse and Caso, Valeria}},
issn = {{2396-9873}},
keywords = {{guidelines; menopause; postpartum; pregnancy; Stroke; women}},
language = {{eng}},
number = {{2}},
publisher = {{SAGE Publications}},
series = {{European Stroke Journal}},
title = {{European Stroke Organisation guidelines on stroke in women : Management of menopause, pregnancy and postpartum}},
url = {{http://dx.doi.org/10.1177/23969873221078696}},
doi = {{10.1177/23969873221078696}},
volume = {{7}},
year = {{2022}},
}