Literature is scarce regarding the use of clopidogrel during pregnancy and the potential hazard to maternal and fetal health. We report a 33-year-old female, who presented to our clinic at 40 weeks gestation with a history of multiple prior ischemic strokes and transient ischemic attacks. The patient was placed on clopidogrel for secondary stroke prophylaxis prior to conception and maintained therapy throughout pregnancy without interruption or complication. Clopidogrel was discontinued 7 days prior to induction of labor, and a healthy baby was vaginally delivered without bleeding complications or congenital anomalies. Clopidogrel was restarted 12 hours postpartum without an incident. To our knowledge, this is the first report of clopidogrel use in pregnancy for secondary stroke prophylaxis. We also provide a current review of the literature of the use of clopidogrel in pregnancy. Based on the limited data available, clopidogrel use in pregnancy has not demonstrated significant toxicity to either the mother or the newborn. However, additional studies are needed to further assess the efficacy and safety of this medication in this patient population.
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http://dx.doi.org/10.1007/s00404-014-3269-6 | DOI Listing |
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome (ACS), particularly in postpartum women without traditional cardiac risk factors. Our case involves a 29-year-old postpartum woman who presented with severe substernal chest pain eight days after an emergency cesarean section for pregnancy-associated hypertension. Electrocardiography showed ST elevation in the inferior and posterior leads, and coronary angiography revealed a spontaneous dissection in the left circumflex artery (LCx) with an intramural hematoma, alongside a dissection of the right coronary artery (RCA) extending from the ostium to the mid-vessel.
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October 2024
Cardiovascular Division, Department of Medicine, 1600 NW 10th Ave, University of Miami Miller School of Medicine, Miami, FL 33136, United States.
JACC Adv
June 2024
Raquel and Jaime Gilinski Department of Obstetrics, Gynecology, and Reproductive Science, New York, New York, USA.
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