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Postpartum eclampsia complicated by reversible cerebral herniation.

Victoria Belogolovkin1, Steven R Levine, Madeline C Fields

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Mount Sinai Medical Center, NY 10029-6574, USA. Victoria.Belogolovkin@MSSM.edu

Obstetrics and Gynecology
|February 2, 2006
PubMed
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Late postpartum preeclampsia complicated by posterior reversible encephalopathy syndrome can lead to cerebral herniation. Magnetic resonance imaging aids in assessing disease severity in these cases.

Area of Science:

  • Neurology
  • Obstetrics
  • Radiology

Background:

  • Preeclampsia and eclampsia are significant causes of maternal morbidity and mortality.
  • Posterior reversible encephalopathy syndrome (PRES) is a recognized neuroradiologic finding in preeclampsia/eclampsia.
  • Late postpartum onset of these conditions presents unique clinical challenges.

Observation:

  • A 39-year-old woman presented with late postpartum preeclampsia on day 4 postpartum.
  • She developed eclampsia and PRES, confirmed by MRI.
  • This was followed by clinical and radiological evidence of reversible cerebral herniation.

Findings:

  • This case represents the first reported instance of late postpartum eclampsia with PRES and subsequent reversible cerebral herniation.
  • The combination of conditions highlights a severe spectrum of postpartum hypertensive disorders.

Related Experiment Videos

  • Neuroradiologic imaging proved crucial for diagnosis and assessing the extent of neurological involvement.

    • Implications:

    • Postpartum preeclampsia/eclampsia complicated by PRES can precipitate cerebral herniation.
    • Early and accurate diagnosis using neuroradiologic imaging is vital for predicting and managing disease severity.
    • This underscores the importance of continued postpartum surveillance for hypertensive disorders.