2018
Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy
Ladhani NNN, Swartz RH, Foley N, Nerenberg K, Smith EE, Gubitz G, Dowlatshahi D, Potts J, Ray JG, Barrett J, Bushnell C, Bal S, Chan WS, Chari R, Amrani M, Gandhi S, Hill MD, James A, Jeerakathil T, Jin A, Kirton A, Lanthier S, Lausman A, Leffert LR, Mandzia J, Menon B, Pikula A, Poppe A, Saposnik G, Sharma M, Bhogal S, Smitko E, Lindsay MP. Canadian Stroke Best Practice Consensus Statement: Acute Stroke Management during pregnancy. International Journal Of Stroke 2018, 13: 743-758. PMID: 30021491, DOI: 10.1177/1747493018786617.Peer-Reviewed Original ResearchConceptsAcute stroke managementStroke managementConsensus statementPost-stroke managementSecondary stroke preventionAcute stroke treatmentGroup of patientsInitial emergency managementBest available literatureStroke preventionAcute strokePostpartum managementAnesthetic managementHemorrhagic strokeStroke treatmentObstetric carePregnant womenMaternal healthPrior historyClinical considerationsConsensus documentPregnancyExpert consensusStrokeHealthcare professionals
2017
Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy
Swartz RH, Ladhani NNN, Foley N, Nerenberg K, Bal S, Barrett J, Bushnell C, Chan WS, Chari R, Dowlatshahi D, Amrani ME, Gandhi S, Gubitz G, Hill MD, James A, Jeerakathil T, Jin A, Kirton A, Lanthier S, Lausman A, Leffert LR, Mandzia J, Menon B, Pikula A, Poppe A, Potts J, Ray J, Saposnik G, Sharma M, Smith EE, Bhogal S, Smitko E, Lindsay MP. Canadian stroke best practice consensus statement: Secondary stroke prevention during pregnancy. International Journal Of Stroke 2017, 13: 406-419. PMID: 29171360, DOI: 10.1177/1747493017743801.Peer-Reviewed Original ResearchMeSH KeywordsAnticoagulantsAntihypertensive AgentsCanadaCounselingDiabetes, GestationalDiabetic AngiopathiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypertensionIschemic Attack, TransientPlatelet Aggregation InhibitorsPostnatal CarePreconception CarePregnancyPregnancy Complications, CardiovascularPregnancy in DiabeticsPrenatal CareProfessional PracticeRisk FactorsSecondary PreventionStrokeConceptsSecondary stroke preventionStroke preventionConsensus statementUse of antithromboticsTransient ischemic attackBlood pressure managementIschemic stroke etiologyAspects of pregnancyHealth care professionalsGeneral management considerationsBest available literatureIschemic attackRecurrent strokeLipid managementStroke etiologyStroke riskFetal healthMaternal healthPrior historyFetal wellbeingCare professionalsClinical considerationsPregnancyConsensus documentExpert consensusThe incidence of pregnancy-related stroke: A systematic review and meta-analysis
Swartz RH, Cayley ML, Foley N, Ladhani NNN, Leffert L, Bushnell C, McClure J, Lindsay MP. The incidence of pregnancy-related stroke: A systematic review and meta-analysis. International Journal Of Stroke 2017, 12: 687-697. PMID: 28884652, DOI: 10.1177/1747493017723271.Peer-Reviewed Original ResearchMeSH KeywordsCanadaFemaleHumansIncidencePostpartum PeriodPregnancyPregnancy Complications, CardiovascularPuerperal DisordersRisk FactorsStrokeConceptsCerebral venous sinus thrombosisVenous sinus thrombosisPregnancy-related strokeSinus thrombosisStroke incidenceCrude rateSystematic reviewIncidence of strokeHigh-risk populationConclusions StrokePostpartum strokeNonhemorrhagic strokeIschemic strokePregnancy populationStroke riskPerinatal strokePooled analysisSubgroup analysisObstetrical careIncidence rateStroke typeOvid MEDLINEInclusion criteriaStroke ratePregnancyNeuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin
Leffert LR, Dubois HM, Butwick AJ, Carvalho B, Houle TT, Landau R. Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin. Anesthesia & Analgesia 2017, 125: 223-231. PMID: 28628578, DOI: 10.1213/ane.0000000000002173.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnesthesia, ConductionAnesthesia, ObstetricalAnesthesiologyAnestheticsAnticoagulantsCesarean SectionDelivery, ObstetricFemaleHematoma, Epidural, SpinalHeparinHeparin, Low-Molecular-WeightHumansMiddle AgedNerve BlockPregnancyPregnancy Complications, CardiovascularThrombosisYoung AdultConceptsSpinal epidural hematomaCases of SEHNeuraxial anesthesiaObstetric patientsVenous thromboembolismWeight heparinAnesthesia Closed Claims Project databaseSystematic reviewPractice changePostpartum venous thromboembolismVaginal delivery hospitalizationsWeight heparin doseRisk of thromboembolismLarge-scale registriesMajority of womenEnglish-language studiesAnticoagulated womenDelivery hospitalizationsPharmacological thromboprophylaxisAnticoagulant doseCesarean deliveryEpidural hematomaHeparin doseVaginal deliveryGeneral anesthesia
2016
Risk of Pregnancy-Associated Stroke Across Age Groups in New York State
Miller EC, Gatollari HJ, Too G, Boehme AK, Leffert L, Elkind MS, Willey JZ. Risk of Pregnancy-Associated Stroke Across Age Groups in New York State. JAMA Neurology 2016, 73: 1461-1467. PMID: 27775757, DOI: 10.1001/jamaneurol.2016.3774.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsFemaleHumansIncidenceNew YorkPregnancyPregnancy Complications, CardiovascularPuerperal DisordersRiskStrokeYoung AdultConceptsPregnancy-associated strokePregnant/postpartum womenRisk of strokeIncidence risk ratioRisk factorsPostpartum womenAge groupsNonpregnant womenStroke riskOlder womenCumulative riskAge-specific incidence ratiosPost partumCalendar year 2003Cerebral venous thrombosisStroke risk factorsTransient ischemic attackVascular risk factorsOverall median ageLogistic regression modelsActive smokingChronic hypertensionIschemic attackNPAS groupCerebrovascular events
2015
Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy
Leffert LR, Clancy CR, Bateman BT, Cox M, Schulte PJ, Smith EE, Fonarow GC, Schwamm LH, Kuklina EV, George MG. Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy. Circulation Cardiovascular Quality And Outcomes 2015, 8: s170-s178. PMID: 26515206, DOI: 10.1161/circoutcomes.115.002242.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsCerebral HemorrhageFemaleHospital MortalityHumansLogistic ModelsPregnancyPregnancy Complications, CardiovascularPregnancy OutcomeRisk FactorsStrokeSubarachnoid HemorrhageYoung AdultConceptsStroke risk factorsSubarachnoid hemorrhage patientsHemorrhagic strokeRisk factorsHS patientsHospital mortalityHemorrhage patientsDiseases-Ninth Revision codesBlood pressure criteriaGuidelines-Stroke registryPregnancy-related strokeAssociation of pregnancyNonpregnant female patientsConditional logistic regressionFisher's exact testWilcoxon rank sum testRank sum testGuidelines-StrokeSevere preeclampsiaHome dischargeIschemic strokeNonpregnant womenPatient characteristicsRisk patientsIndependent ambulationHypertensive Disorders and Pregnancy-Related Stroke
Leffert LR, Clancy CR, Bateman BT, Bryant AS, Kuklina EV. Hypertensive Disorders and Pregnancy-Related Stroke. Obstetrics And Gynecology 2015, 125: 124-131. PMID: 25560114, PMCID: PMC4445352, DOI: 10.1097/aog.0000000000000590.Peer-Reviewed Original ResearchConceptsTraditional stroke risk factorsPregnancy-associated strokeHypertensive disordersPregnancy hospitalizationsStroke risk factorsStroke-related complicationsStroke riskRisk factorsOdds ratioNationwide Inpatient SampleCongenital heart diseaseCross-sectional studyComplication rateStroke hospitalizationsInpatient SampleHeart diseaseNationwide rateHospitalizationPregnancyStrokeLogistic regressionCongenital coagulationDisordersConfidence intervalsComplications
2012
Peripartum Subarachnoid Hemorrhage
Bateman B, Olbrecht V, Berman M, Minehart R, Schwamm L, Leffert L. Peripartum Subarachnoid Hemorrhage. Anesthesiology 2012, 116: 324-333. PMID: 22166951, DOI: 10.1097/aln.0b013e3182410b22.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCohort StudiesDatabases, FactualFemaleHospitalizationHumansHypertensionIntracranial AneurysmPeripartum PeriodPregnancyPregnancy Complications, CardiovascularRisk FactorsSubarachnoid HemorrhageUnited StatesYoung AdultConceptsSubarachnoid hemorrhageHypertensive disordersRisk factorsPregnancy-related admissionsIndependent risk factorIntracranial venous thrombosisNationwide Inpatient SampleAfrican American raceVariety of etiologiesRange of etiologiesSickle cell diseaseIdentified admissionsHospital deathMaternal morbidityNonpregnant patientsNonpregnant womenIndependent predictorsMalignant etiologySevere headacheVenous thrombosisNonpregnant controlsPregnancy resultsVenous bleedingInstitution experienceInpatient Sample
2008
Acute Reversible Stress-Induced Cardiomyopathy Associated with Cesarean Delivery under Spinal Anesthesia
Crimi E, Baggish A, Leffert L, Pian-Smith MC, Januzzi JL, Jiang Y. Acute Reversible Stress-Induced Cardiomyopathy Associated with Cesarean Delivery under Spinal Anesthesia. Circulation 2008, 117: 3052-3053. PMID: 18541755, DOI: 10.1161/circulationaha.107.744102.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAdultAnesthesia, SpinalCesarean SectionElectrocardiographyFemaleHumansPregnancyPregnancy Complications, CardiovascularRadiographyTakotsubo Cardiomyopathy