Missed Diagnostic Opportunities Identified in Pregnancy-Related Stroke

THURSDAY, Feb. 5, 2026 (HealthDay News) — More than one in four pregnant or postpartum patients with acute stroke experience missed diagnostic opportunities (MDO), according to a study published online Jan. 26 in Stroke.

Noora Haghighi, from Columbia University in New York City, and colleagues conducted a retrospective study involving patients aged 18 to 50 years and pregnant or within one year of delivery treated at five U.S. stroke centers for confirmed arterial ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral venous thrombosis.

The researchers found that 37 (27 percent) of the 135 patients with pregnancy-related stroke had MDO. Focal neurological deficits, headache, systemic symptoms, and altered mental status were included as presenting symptoms (57, 53, 26, and 19 percent, respectively). More patients with versus without MDO had hemorrhagic strokes (22 of 37 [59 percent] versus 34 of 79 [43 percent]). Ninety-two percent of patients with MDO had one or more documented medical encounters in the month preceding stroke diagnosis compared with 59 percent of patients without MDO. Of the 86 patients with prestroke encounters, 49 and 29 percent were evaluated by obstetricians and emergency medicine clinicians, respectively. Among patients with MDO, failure to recognize symptoms and omission of appropriate neuroimaging studies were contributing factors (84 and 81 percent, respectively); in 95 percent of patients, the clinical presentation was judged typical of the final stroke diagnosis.

“Our findings show that early warning signs are often missed, especially by clinicians without neurology training, and that education across specialties is essential,” senior author Eliza C. Miller, M.D., from the University of Pittsburgh, said in a statement.

Several authors disclosed ties to the biopharmaceutical and health care industries.

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