ReviewJournal of investigative medicine : the official publication of the American Federation for Clinical Research2016
Patent foramen ovale (PFO), stroke and pregnancy.
Review in Journal of investigative medicine : the official publication of the American Federation for Clinical Research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 52 citations in OpenAlex.
- Diagnosis and Management of Patients with Patent Foramen Ovale: Current Evidence and Future Perspective.Journal of cardiovascular development and disease · 2026Review
- Patent Foramen Ovale-Induced Hypoxemia Unmasked During Pregnancy.JACC. Case reports · 2026Article
- Article
- Right-to-left shunt and transcranial Doppler as a diagnostic tool: when and how to run it. Position statement by the Italian society of neurosonology and cerebral haemodynamics.Frontiers in neurology · 2025Review
- Paradoxical embolisation to the brain in right-sided infective endocarditis and patent foramen ovale in a pregnant woman.BMJ case reports · 2023Article
- Heart-brain axis: Association of congenital heart abnormality and brain diseases.Frontiers in cardiovascular medicine · 2023Review
- Recent progress in patent foramen ovale and related neurological diseases: A narrative review.Frontiers in neurology · 2023Review
- A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke.Current atherosclerosis reports · 2022Review
- A Review on Preclinical Models of Ischemic Stroke: Insights Into the Pathomechanisms and New Treatment Strategies.Current neuropharmacology · 2022Review
- Retinal vascular occlusion in pregnancy: three case reports and a review of the literature.Journal of medical case reports · 2022Review
- European position paper on the management of patients with patent foramen ovale. Part II - Decompression sickness, migraine, arterial deoxygenation syndromes and select high-risk clinical conditions.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Article
- Stroke in Pregnancy: A Multidisciplinary Approach.Obstetrics and gynecology clinics of North America · 2021Review
- Residual Shunt After Patent Foramen Ovale Closure and Long-Term Stroke Recurrence: A Prospective Cohort Study.Annals of internal medicine · 2020Article
- Ischemic stroke and cerebral venous sinus thrombosis in pregnancy.Handbook of clinical neurology · 2020Review
- Management of Maternal Stroke and Mitigating Risk.Current treatment options in cardiovascular medicine · 2019Review
- Secondary Headaches During Pregnancy: When to Worry.Current neurology and neuroscience reports · 2019Review
- Management of stroke and pregnancy.European stroke journal · 2018Review
- Causes and Treatment of Acute Ischemic Stroke During Pregnancy.Current treatment options in neurology · 2018Review
- Pregnancy-Associated Stroke.Journal of midwifery & women's health · 2018Review
- Lesson of the month 2: Use of thrombolysis for ischaemic stroke in pregnancy - a case report and review of literature.Clinical medicine (London, England) · 2017Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
Patent foramen ovale (PFO)-related stroke is increasingly recognized as an important etiology of ischemic embolic stroke-accounting for up to 50% of strokes previously considered 'cryptogenic' or with an unknown mechanism. As a 'back door to the brain,' PFO can allow venous clots to enter arterial circulation via interatrial right-to-left shunting, potentially resulting in ischemic stroke. We observe that clinically, PFO-related stroke affects women of childbearing age, and that pregnancy-owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters-can enhance stroke risks. However, no systematic study has been performed and little is known regarding complications, pregnancy outcomes and treatment for PFO-related stroke during pregnancy. To identify and characterize the complications and clinical outcomes related to PFOs during pregnancy, we performed a literature review and analysis from all reported cases of pregnancy with PFO-related complications in the medical literature from 1970 to 2015. We find that during pregnancy and post-partum, PFO is associated with complications affecting multiple organs, including the brain, heart and lung. The three principal complications reported are stroke, pulmonary emboli and myocardial infarction. In contrast to other pregnancy-related stroke etiologies, which peak during later pregnancy and postpartum, PFO-related stroke peaks during early pregnancy (first and second trimester-60%), and most patients had good neurological outcome (77%). In patients with PFO with recurrent stroke during pregnancy, additional key factors include high-risk PFO morphology (atrial septal aneurysm), larger right-to-left shunt, multiple gestation and concurrent hypercoagulability. Compared to strokes of other etiologies during pregnancy, most PFO stroke patients experienced uneventful delivery (93%) of healthy babies with a good clinical outcome. We conclude with recommended clinical treatment strategies for pregnant patients with PFO suggested by the data from these cases, and the clinical experience of our Cardio-Neurology Clinic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.