Stroke Education for Obstetric Providers: A Single-Center Pilot Following a Case of Delayed Recognition of Postpartum Intracerebral Hemorrhage

Abstract

Background: Stroke is three times more likely in obstetric patients than in age-adjusted non-pregnant women. No studies have focused on obstetric provider education for stroke management. A case of a postpartum woman with intracerebral hemorrhage at a large obstetrics hospital spurred modification of the code stroke protocol and an educational seminar on neurologic emergencies geared towards obstetric providers. The effectiveness of stroke triage training to improve understanding of management in obstetric patients was assessed.

Methods: Obstetric providers were assessed before and after attending a 1-h educational seminar by stroke experts from the affiliated comprehensive stroke center at an associated large academic institution. The knowledge assessment included seven questions about concerning symptoms and initial steps in management of suspected stroke.

Results: Twenty-eight out of 48 participants completed before and after knowledge assessments. The average increase in point score was 1.25 (21%). The greatest post-education increases occurred regarding blood pressure augmentation during a stroke alert (18% to 82% correct) and initial tests needed for evaluation (36% to 89% correct). Providers learned head imaging must be obtained to differentiate between types of strokes before treating hypertension, and labs, except finger stick glucose, are not needed before administering a thrombolytic.

Conclusions: Obstetric patients are at increased risk of stroke, and targeted clinician education can improve knowledge of initial management steps. Obstetric practices should consider additional education for nurses and providers on managing stroke, as proper stroke management is time sensitive and can reduce maternal mortality.

J Clin Gynecol Obstet. 2024;13(1):1-7
doi: https://doi.org/10.14740/jcgo943