Objective — to identify the incidence of thrombophilia in pregnant women after acute cerebrovascular accident (ACVA) and to determine the informative value of a global hemostatic test, such as thrombodynamics, to monitor anticoagulant therapy. Subject and methods. A follow-up was conducted in 86 pregnant women with cerebrovascular diseases: 45 pregnant women with prior ischemic stroke (IS), 41 patients with hemorrhagic stroke (HS), 13 (28.9%) pregnant women with IS and 7 (17.1%) patients with HS had ACVA during the current pregnancy; the others had a history of stroke. The pregnant women were divided into 2 groups according to the presence of thrombophilia: 1) 30 patients with concomitant thrombophilic disorders; 2) 56 pregnant women without thrombophilia. The hemostatic system was studied in pregnant women with ACVA over time prior to the administration of heparin and at its peak concentration. Results. The screening showed that the number of thrombophilia cases was amounted to 31 and 39% in the pregnant women with IS and HS, respectively. This confirms that this condition is one of the potential causes of ACVA. Examination of the hemostatic system revealed that hypercoagulation was more obvious in pregnant women with thrombophilia who received anticoagulant therapy under guidance of the hemostatic system. In Group 2, the number of patients with no identified thrombophilia took anticoagulants for the prevention of a recurrence of the disease. The use of anticoagulants statistically significantly improved hemostatic indicators. The administration of anticoagulants at preventive doses did not lead to bleeding, but prevented thrombotic events in childbirth and the postpartum period, including in patients with ACVA during pregnancy. Conclusion. Thrombodynamics versus standard hemostasis assessment methods and thromboelastometry is more sensitive to hypercoagulation and may be used to monitor anticoagulant therapy in pregnant women with ACVA. The authors declare no conflicts of interest.