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Cocaine intoxication presenting as preeclampsia and eclampsia

C V Towers1, R A Pircon, M P Nageotte

  • 1Department of Obstetrics and Gynecology, University of California, Irvine, Orange.

Obstetrics and Gynecology
|April 1, 1993
PubMed
Summary

Acute cocaine intoxication in late pregnancy mimics preeclampsia. Symptoms like hypertension and seizures rapidly resolved after admission, differentiating it from true preeclampsia in pregnant patients.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Toxicology

Background:

  • Preeclampsia is a serious pregnancy complication characterized by hypertension and organ damage.
  • Differentiating drug-induced conditions from obstetric emergencies is crucial for accurate diagnosis and management.

Observation:

  • Eleven pregnant women in their third trimester presented with symptoms mimicking preeclampsia, including hypertension, headache, blurred vision, abdominal pain, and seizures.
  • All patients had a positive urine drug screen for cocaine.
  • Hypertension and symptoms resolved within 45-90 minutes of admission.

Findings:

  • Despite presenting with signs and symptoms typical of preeclampsia, all laboratory evaluations for preeclampsia were negative.
  • The rapid improvement of symptoms and normalization of blood pressure upon admission suggested an alternative diagnosis.

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Implications:

  • Acute cocaine intoxication can present as a hypertensive disorder in the third trimester, closely resembling preeclampsia.
  • Clinicians should consider cocaine intoxication in pregnant patients with third-trimester hypertension and preeclampsia-like symptoms that rapidly improve after hospital admission.