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Published on: November 20, 2015
Low neonatal birth weight as a possible predictive factor for the onset of postpartum eclampsia
Chiara Tersigni1, Giuseppe Esposito, Alessio Albanese
1Institute of Obstetrics and Gynaecology, Catholic University School of Medicine, Largo A. Gemelli 8, Rome, Italy.
Objective:
To report about a case of complicated late postpartum eclampsia where neonatal low birth weight could be considered a predictive factor of placental sufferance.
Methods:
A 25-year-old woman, without medical or familiar history for hypertension or cerebrovascular diseases, underwent a normal spontaneous delivery with neonatal birth weight of 2340 g (9th percentile). Eight days later the patient presented sudden headache and generalized tonic-clonic seizures.
Results:
Blood hypertension and alterations in laboratory studies were detected; a diagnosis of late postpartum eclampsia was made. A CT scan showed subarachnoid hemorrhage (Hunt and hess grade I, Fisher grade III). Serial cerebral angiograms did not show any intracranial vascular malformations; epilepsy and hypertension were successfully medically treated; and a repeat CT examination showed the gradual resolution of subarachnoid hemorrhage. Headache progressively disappeared.
Conclusions:
Low neonatal birth weight could be linked to placental dysfunction and considered as a predictive factor for the onset of postpartum preeclampsia/eclampsia. We recommend a careful clinical and laboratory management of puerperium up to the first month postpartum, in particular in cases of "sine causa" neonatal low birth weight.
