Disclosures: Ryan L. Smith, DO: No financial relationships or conflicts of interest

Case Diagnosis: A patient with a severe postpartum stroke showed impressive functional gains after increased visitation from newborn during her rehabilitation course.

Case Description or Program Description: Patient AF presented after a complex pregnancy and partum course complicated by placental abruption, 4th degree perineal tear, pre-eclampsia with severe features and hemorrhagic shock. Postpartum she suffered a right internal carotid stroke, was given thrombolytics and developed subsequent hemorrhagic transformation resulting in L sided facial droop and severe L hemiparesis. After medical stabilization, the patient was admitted to a separate freestanding inpatient rehabilitation hospital for 3 weeks and daily physical, occupational and speech therapy. Initially COVID-19 visitation restrictions did not allow her newborn to visit more than 1 hour every other day, one week after an admission and after a medical appeal a visitation exception was granted for 5 hours daily with her newborn for the remaining 2 weeks of her stay. Her initial functional independence measure scores remained unchanged after the initial week at the rehabilitation hospital, but functional recovery in the subsequent two weeks was profoundly improved with daily contact with her newborn. Total Functional Independence Measure scores across 11 domains increased from 40/77 to 60/77 during her last two weeks of rehabilitation. Patient especially showed impressive progress in ambulatory ability, initially she was able to walk 20 ft with minimum assistance in the parallel bars and by discharge she was ambulating 200 ft moderate assistance with a single point cane.

Setting: Inpatient Rehabilitation Hospital

Assessment/Results: The drastic improvement in this patient’s functional status after increased contact with her newborn exemplifies the important role of the newborn in maternal stroke recovery.

Discussion (relevance): The unfortunate nature of COVID-19 visitation limitations has created a unique opportunity to understand the importance of mother and newborn contact in the functional recovery from postpartum cerebrovascular accidents.

Conclusions: Mother and newborn proximity is vital in the recovery of postpartum cerebrovascular accidents, and warrants further investigation to understand the emotional, motivational, and physiological mechanisms of neurological recovery from these injuries.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/functional-improvement-in-a-post-partum-stroke-before-and-after-maternal-separation-from-newborn-due-to-covid-19-visitation-restrictions-a-case-report/