DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222624
Published: 2022-10-28

Postpartum eclampsia: a clinical study

Deepika T. Thomas, Usha Vishwanath

Abstract


Background: Eclampsia, an enigmatic multisystem complication of pregnancy, is commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum. Eclampsia is associated with maternal deaths ranging from, 1.8% in developed to 14% in developing countries respectively. The worldwide incidence of delayed postpartum eclampsia is on an increasing trend, now at 16-18%, of all eclamptic seizures. Objective was to study the clinical findings and morbidity, associated with postpartum eclampsia and its correlation with neuroimaging- in our institute- SRIHER, Chennai.

Methods: This is a retrospective study from a period of June 2016 to June 2021, in SRIHER, Chennai. Case records of all patients with postpartum eclampsia were analysed.

Results: A total of 35 patients who satisfied the inclusion criteria were studied, out of which 55% of patients were diagnosed with hypertension or preeclampsia antenatally, and 45% presented as atypical eclampsia. In our institution, Postpartum eclampsia commonly occurred in the age group of 26-30 years of age (51.4%); was common after lower segment caesarean section (LSCS) (71.4%); most commonly occurred immediate postpartum (42.8%). Most common prodromal symptom was headache (77%), followed by blurring of vision (37%). Most common magnetic resonance imaging (MRI) finding was posterior reversible encephalopathy syndrome (PRES) (69%). 17% patients required intensive care unit (ICU) care. There was no mortality associated with postpartum eclampsia in the study period.

Conclusions: This study emphasises that a high index of suspicion and a multidisciplinary approach effectively reduces mortality and morbidity associated with postpartum eclampsia. Neuroimaging is of robust help in the diagnosis and management of postpartum eclampsia.

 


Keywords


Eclampsia, Neuroimaging, Postpartum eclampsia, PRES

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References


Al-Safi Z, Imudia AN, Filetti LC, Hobson DT, Bahado-Singh RO, Awonuga AO. Delayed postpartum preeclampsia and eclampsia: demographics, clinical course, and complications. Obstet Gynecol. 2011;118(5):1102-7.

Bharathi R, Sundari KPM, Jayanthi RD. Clinical study of post-partum eclampsia in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5(11):3728-30.

Gupte S, Wagh G. Preeclampsia-eclampsia. J Obstet Gynaecol India. 2014;64(1):4-13.

Misra R. Ian Donald's Practical Obstetrics Problems. Wolters Kluwer India Pvt Ltd. 2014.

Minnerup J, Kleffner I, Wersching H, Zimmermann J, Schäbitz WR, Niederstadt T, Dziewas R. Late Onset Postpartum Eclampsia: It is Really Never Too Late-A Case of Eclampsia 8 Weeks after Delivery. Stroke Res Treat. 2010;798616.

Singh BM, Mishra R. Hypertensive disorders. Mishra R, editor. Ian Donalds Practical Obstetric Problem, Seventh edition. BI Publications Pvt Ltd: New Delhi. 2014:142-75.

Corton M, Leveno K, Bloom S, Dashe J, Spong C. Williams obstetric 24th edition. McGraw Hill Education. 2014.