Fatal Stroke in Pregnancy and the Puerperium Case Series

Background and Purpose-Fatal stroke during pregnancy and the puerperium is rare. Pregnancy-related hypertension and vascular abnormalities underlie significant proportions of pregnancy-related stroke, but up to one-quarter are of no known cause. Methods-Case series of fatal pregnancy-related stroke. All cases where the cause of death was attributed to stroke during pregnancy/postpartum were retrieved from the National Coronial Information System database (January 1, 2009 to December 31, 2016). Results-Fourteen fatal strokes were identified, all hemorrhagic in origin. Underlying causes included pregnancy-related hypertension, rupture of vascular malformations, vasculitis, and cardiomyopathy. Conclusions-Fatal pregnancy-related stroke occurred secondary to hemorrhages of heterogeneous causes, including pregnancy-related hypertension and previously undiagnosed risk factors.