In pregnancy-associated ischemic stroke, tPA is considered when?

In pregnancy-associated ischemic stroke, tPA is considered when?

• A. Within 4.5 hours on a case-by-case basis
• B. For all strokes immediately
• C. Never due to pregnancy
• D. Only after delivery

Answer: (A)

In pregnancy-associated ischemic stroke, treating with IV tPA is not automatic; it depends on timing and safety. The key idea is that thrombolysis is time-sensitive, with a standard window of within 4.5 hours from onset for IV tPA in acute ischemic stroke. In a pregnant patient, you still weigh maternal benefit against potential fetal and maternal risks, and you decide on a case-by-case basis after careful imaging and multidisciplinary input. If the patient presents within that 4.5-hour window and there are no contraindications (such as active bleeding or high bleeding risk, and imaging shows no hemorrhage), IV tPA can be considered. Outside that window or with significant contraindications, it isn’t indicated. Options that imply tPA is always given, never given, or only after delivery don’t reflect this nuanced, time- and risk-based approach.

In pregnancy-associated ischemic stroke, treating with IV tPA is not automatic; it depends on timing and safety. The key idea is that thrombolysis is time-sensitive, with a standard window of within 4.5 hours from onset for IV tPA in acute ischemic stroke. In a pregnant patient, you still weigh maternal benefit against potential fetal and maternal risks, and you decide on a case-by-case basis after careful imaging and multidisciplinary input. If the patient presents within that 4.5-hour window and there are no contraindications (such as active bleeding or high bleeding risk, and imaging shows no hemorrhage), IV tPA can be considered. Outside that window or with significant contraindications, it isn’t indicated. Options that imply tPA is always given, never given, or only after delivery don’t reflect this nuanced, time- and risk-based approach.