The Contribution of Prothrombotic Disorders to Peri- and Neonatal Ischemic Stroke

ABSTRACT

Prothrombotic disorders are believed to be important contributors to the etiology of peri- and neonatal arterial ischemic stroke and sinovenous thrombosis, which may lead to life-long disability. This article reviews hematological issues unique to the perinatal period, including: the significance of the placenta as the interface between maternal and fetal circulations; normal changes in the coagulation system of mothers during and just after gestation; and the significance of prothrombotic disorders in the mother and/or fetus. Other possible maternal and neonatal contributors to peri- and neonatal stroke are discussed, including: infection, pre-eclampsia, diabetes, and drug use in the mother; and infection, dehydration, complex congenital heart disease, extracorporeal membrane oxygenation, and catheter placement in the neonate. Possible approaches to preventing and treating perinatal and neonatal stroke are presented.

KEYWORDS

Arterial ischemic stroke - sinovenous thrombosis - cerebrovascular accident - neonatal stroke - perinatal stroke - pregnancy - puerperium - placenta - prothrombotic disorder - coagulation

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