Objective — to analyze the course of pregnancy and labor and perinatal outcomes and to optimize delivery tactics in women with ischemic stroke. Subject and methods. Fifty pregnant women with ischemic stroke, including 14 pregnant women in whom stroke had occurred during pregnancy and 36 patients who had a history of acute cerebrovascular accident as ischemic stroke, were examined. Their laboratory study involved hemostatic system examination, screening for inherited thrombophilias, thromboelastometry, and thrombodynamic studies. The central nervous system was investigated by brain magnetic resonance imaging and computed tomography. The pregnant patients were treated at neurology hospital according to the accepted standards, by necessarily involving an obstetrician/gynecologist, a neurologist, a neurosurgeon, an oculist, and an anesthetist. Results. In the patients who had experienced ischemic stroke before and during pregnancy, the outcomes of pregnancy and labor might be favorable when an obstetrician/gynecologist, a neurologist, a neurosurgeon, an oculist, and an anesthetist had necessarily to jointly manage these patients. The use of anticoagulants in preventive doses in these pregnant women caused no increase in the rate of bleeding and recurrent ischemic stroke. Anticoagulant therapy requires monitoring using thromboelastometry, thrombodynamic study, and anti-Xa factor assay. Optimized management of patients with ischemic stroke with the participation of a group of the specialists can safely increase the rate of vaginal delivery in these patients. Conclusion. The setting-up of reginal centers is promising in specifying the diagnosis, the specific features, and further follow-up of patients with ischemic stroke. The authors declare no conflicts of interest.