AHA Issues Guidance on Preventing and Treating Maternal Stroke in Scientific Statement

The American Heart Association (AHA) has released a scientific statement providing comprehensive, consensus-based guidance on the prevention, acute management, and care of maternal stroke during pregnancy and the postpartum period. The statement, endorsed by the American College of Obstetricians and Gynecologists and published in Stroke, is intended to address a longstanding gap in stroke in a population that has historically been excluded from major stroke trials despite rising incidence and substantial morbidity and mortality.

The scientific statement was developed by a multidisciplinary writing panel consisting of clinical experts in vascular neurology, maternal-fetal medicine, obstetric anesthesiology, cardio-obstetrics, vascular neurosurgery, emergency medicine, and stroke nursing. The group reviewed available observational data, prior AHA/American Stroke Association (ASA) stroke guidelines, obstetric guidance, and emerging evidence related to pregnancy-associated cerebrovascular disease.

Key recommendations and considerations include the following:

• Pregnancy should not delay evidence-based evaluation or treatment of acute stroke, including thrombolysis or thrombectomy when clinically appropriate.
• CT, CT angiography, and MRI without contrast are considered safe and should be used promptly to evaluate suspected stroke.
• Aggressive recognition and treatment of severe hypertension (≥160/110 mmHg) during pregnancy and postpartum is emphasized as a cornerstone of stroke prevention.
• Acute stroke alone is not an indication for immediate delivery; maternal stabilization should take priority, with vaginal delivery preferred when feasible.
• Survivors of pregnancy-associated stroke require coordinated postpartum care, including blood pressure monitoring, secondary stroke prevention, mental health screening, and multidisciplinary rehabilitation.

Source: Miller EC, Bello NA, Chen PR, et al. Prevention and treatment of maternal stroke in pregnancy and postpartum: a scientific statement from the American Heart Association. Stroke. Published 28 January, 2026. doi:10.1161/STR.0000000000000514