In the ninth month of her pregnancy, in the middle of a lecture, she had a stroke – the doctors fought for her life

A, 38 years old from Jerusalem, presenter of health workshops was in the ninth month of her pregnancy. During a workshop led by her, she suddenly couldn’t get words out of her mouth. A tried to rest and recover. While she is trying to get the words out of her mind, without success, one of the workshop participants who knows well the signs of a stroke, as her father recently experienced a stroke, called without hesitation and called an ambulance that arrived immediately.

The medics of Ihud Hatzla immediately diagnosed that A was in the midst of a stroke and ordered an intensive care unit that rushed her to the trauma unit at the Shaarei Zedek Medical Center.

A tells about the critical minutes: "The stroke unit staff greeted me outside the hospital and took me directly to the trauma room. There I was received by Dr. Yosef Schechter from the stroke unit who conducted a questioning and assessment. I was able to think but I could not calculate numbers nor could I retrieve their names. I was able to speak but short sentences. I understood that the situation was not good. After an examination I was told that all the signs indicate a stroke".

After MRI and CT head tests that were performed immediately, a blood clot was found in A’s brain. The doctors of the stroke unit stabilized her condition, with the most significant challenge being the preservation of the pregnancy. Dr. Reot Rotem from the women’s and maternity department at the medical center that treated A. explains: "In light of the acute neurological event and the fear of a repeat event, the main challenge was to maintain a very narrow blood pressure range. Given that the woman was not in the process of giving birth and the fact that she had had a cesarean section in the past, a normal delivery could have exposed the mother to risks that we preferred to avoid.

A. was on time, and after a multidisciplinary consultation, it was decided that the right thing to do was to perform an emergency caesarean section under spinal anesthesia while stabilizing the mother. The anesthesia was performed very professionally by the anesthetists d"R. Freddie Howzi, while maintaining the mother’s blood pressure in a range that does not endanger her life. To our delight, the caesarean section was performed successfully and with great skill by D"R. Hativ Faiz, director of the ambulatory gynecology unit, and a healthy baby was born while preserving the mother’s life".

After the birth, A. is completely confused and has trouble getting numbers out of her mind, but remembers the close supervision of the stroke unit doctors throughout the course of the birth, "The birth ended successfully and the baby was rescued safely. At the end of the operation, they placed the baby on me for a short time, after tests and measurements that came out normal, the baby was transferred to the nursery for the dedicated care of the team of midwives and neonatologists, and I was transferred to the neurological neurosurgical intensive care unit where the doctors and nurses in the department did not move from my bed, for fear of a haunting event". That’s what she says.

In the neurological neurosurgical intensive care unit, headed by D"R. Stefan Mausbach vigilance was high. After performing an ultrasound examination that demonstrated an improvement in the mother’s neurological condition, A was admitted to the neurological ward. Comprehensive tests were performed in the department, including cardiac tests which came out normal. After improving the mother’s condition and coordinating with the mother and newborn wing team, the mother and baby were reunited in the neurology department.

d"Rev. Roni Eichel, director of the stroke unit, explains that a stroke during pregnancy is rare, especially a stroke near the time of birth. "This type of stroke is extremely complex in terms of managing the patient’s care without endangering the mother and the fetus. CT and MRI tests helped accurately diagnose the type of clot, its size and location and allowed us to make the right decisions regarding the timing of the birth and the results were good. The quick and complex preparation and investigation by the experienced and skilled stroke unit team led to the good result.

The main signs of a stroke are weakness in the limbs on one side of the body, difficulty speaking, facial deformity. In the event of the appearance of one or more of these signs, it is recommended to seek treatment at the nearest stroke unit. Awareness of the warning signs can save lives. Also in the case of A, the vigilance of the lecture participant saved her life and the life of the baby. The healthy mother and baby were discharged home in good condition. will continue to be under medical surveillance. We are happy that the event passed with a healthy and intact mother and baby, and we wish the whole family good luck, much happiness and health".

A added: "I thank the Creator of the world for saving the baby, watching over me and sending me good messengers on the way. I thank the professional staff at Shaare Zedek, the nurses, the doctors, the dedicated staff at the nursery who cared professionally and devotedly wrapped the baby and cared for him warmly when I was unable".

Photo: Shaare Tzedek

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