Presentation
The present study reported the case of a 15‑year old female presenting with convulsions that began 5 weeks after delivery. [spandidos-publications.com]
Clinically significant proteinuria was present from 30 weeks onwards. [bmj.com]
Many women who present with postpartum eclampsia have not previously had signs or symptoms of preeclampsia. [exxcellence.org]
Furthermore, this case presents a rare but dangerous presentation of eclampsia. Case report. [ncbi.nlm.nih.gov]
We present a case of a postpartum woman who developed late onset postpartum preeclampsia as well as subsequent intracerebral hemorrhage. [emra.org]
Entire Body System
- Fatigue
Its characteristic symptoms — fatigue, swelling, nausea, shortness of breath, headaches and pain in the back or shoulders — can be difficult to distinguish from more run-of-the-mill maternal complaints. [parenting.nytimes.com]
This could include physical and emotional changes such as: fatigue vaginal discharge or cramping constipation tender breasts sore nipples if you’re breastfeeding feeling blue or weepy, or mood swings problems with sleep and appetite abdominal pain or [healthline.com]
- Crying
I held the spoon up and asked Chris what it was, he told me it was a spoon, I started to panic and cry and told him that I didn't know what it was, so he asked me to sit down. [huffingtonpost.ca]
Gastrointestinal
- Upper Abdominal Pain
abdominal pain, usually under the ribs on the right side Decreased urination If you have signs or symptoms of postpartum preeclampsia shortly after childbirth, contact your health care provider right away. [drugs.com]
abdominal pain, usually under the ribs on the right side Nausea or vomiting Decreased urination Sudden weight gain, typically more than 2 pounds (0.9 kilogram) a week If you have signs or symptoms of postpartum preeclampsia shortly after childbirth, [nchmd.org]
Musculoskeletal
- Fracture
Interactive Medical Cases Image Challenge Images in Clinical Medicine Videos in Clinical Medicine Quick Takes View all multimedia Treating Chronic Spontaneous Urticaria State-Level Action on Drug Prices The Element of Surprise Closed Reduction of a Fractured [nejm.org]
Psychiatrical
- Mood Swings
This could include physical and emotional changes such as: fatigue vaginal discharge or cramping constipation tender breasts sore nipples if you’re breastfeeding feeling blue or weepy, or mood swings problems with sleep and appetite abdominal pain or [healthline.com]
The next day after the patient was discharged, due to that her husband left home to work elsewhere, the patient had mood swings and did not sleep for one night. [qims.amegroups.com]
- Withdrawn
She was noted by the emergency physician to be “withdrawn and quiet.” [ncbi.nlm.nih.gov]
Urogenital
- Oliguria
Persistent oliguria is treated with a carefully monitored fluid challenge. Diuretics are usually not used. [merckmanuals.com]
The patient underwent Cesarean-section, as presumptive diagnosis of eclampsia was made secondary to hypertension, altered mental status, hemoconcentration, and oliguria. [ncbi.nlm.nih.gov]
Close maternal and fetal monitoring by a physician and nursing staff are advised during the treatment of acute-onset, severe hypertension, and judicious fluid administration is recommended even in the case of oliguria. [m.acog.org]
Neurologic
- Headache
[…] have a warning symptom of headache. [consultant360.com]
The postpartum period was uneventful until the 6th day, when she complained of headache and scotoma. [neurologyindia.com]
Review of systems at the time of the Ob-Gyn examination was positive for headaches. The patient was uncooperative with ordered blood work and assessments. Blood pressure of the right leg was obtained at 199/97 mm Hg. [ncbi.nlm.nih.gov]
Eclampsia can consist of many prodromal symptoms including headache, visual changes, right upper quadrant pain, and hypertension. [emra.org]
My headaches started the day after we came home. I figured they were just spinal headaches, so I didn't worry too much. I was also extremely swollen but remembered being swollen after my first C-section, too. [huffingtonpost.ca]
Workup
Ms A was transferred to Ob-Gyn for a postpartum preeclampsia workup. Results of her HELLP (hemolysis, elevated liver enzyme, low platelet count) laboratory measures were within normal limits as was her protein-creatinine ratio. [ncbi.nlm.nih.gov]
If a pregnant woman has already been diagnosed with pre-eclampsia during the current pregnancy and then develops a seizure, she may be assigned a 'clinical diagnosis' of eclampsia without further workup. [en.wikipedia.org]
Treatment
Treatment of anticoagulation, anti-platelet aggregation, cerebral edema reduction, anti-inflammatory treatment and other supportive treatment were administered. [qims.amegroups.com]
Any recently postpartum woman who presents with prodromal symptoms requires early detection and aggressive treatment of pre-eclampsia/eclampsia. This is critical in preventing adverse effects like intracranial hemorrhage. References 1. [emra.org]
Treatment Postpartum preeclampsia may be treated with medication, including: Medication to lower high blood pressure. [drugs.com]
Only a doctor can diagnose postpartum preeclampsia and determine a plan for symptom management and treatment. [flo.health]
Treatment of high blood pressure while breastfeeding requires agreement among the mother, obstetrician, and pediatrician. [preeclampsia.org]
Prognosis
The condition is generally highly treatable, so if your physician is able to catch it early, your prognosis is very good. [fairygodboss.com]
It is important to consider the diagnosis of posterior circulation stroke because its treatment (which may include urgent thrombolysis) and prognosis both differ from those in PRES. [sccj-sa.org]
What Is the Prognosis for a Woman with Eclampsia? Most women will have good outcomes for their pregnancies, even when complicated by preeclampsia or eclampsia. [emedicinehealth.com]
Treatment of PRES With correct diagnosis and timely and effective early treatment, the patient prognosis is usually good. [qims.amegroups.com]
Cerebrovascular complications during pregnancy and postpartum: clinical and prognosis observations in 240 Hispanic women. Eur J Neurol. 2011 ; 18 :819–825. doi: 10.1111/j.1468-1331.2010.03259.x. Crossref Medline Google Scholar 26. [ahajournals.org]
Etiology
Further prospective studies comprising larger sample size and different etiologies of PRES are warranted in this regard. References 1. Niyadurupola N, Burnett CA, Allen LE. [ijo.in]
Postpartum hypertension: Etiology, diagnosis, and management. Obstetrical and Gynecological Survey. 2017; doi:10.1097/OGX.0000000000000424. Redman EK, et al. [mayoclinic.org]
Etiology and pathogenesis of preeclampsia: Current concepts. Am J Obstet Gynecol 1998;179:1359-75. 18. Lin JT, Wang SJ, Fuh JL, Hsiao LT, Lirng JF, Chen PM, et al. Prolonged reversible vasospasm in cyclosporin A-induced encephalopathy. [sccj-sa.org]
Etiology of preeclampsia is unknown. [merckmanuals.com]
The etiology of PRES is not clear. [qims.amegroups.com]
Epidemiology
Alyshah Abdul Sultan, PhD, of the division of epidemiology and public health at the University of Nottingham, and colleagues evaluated data from 168,077 women who had 222,334 pregnancies between 1997 and 2010. [healio.com]
Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011;25:391-403. Watson DM, Sibai BM, Shaver DC, Dacus JV, Anderson GD. Late postpartum eclampsia. An update. [ijrcog.org]
Epidemiology of Preeclampsia and Stroke Hypertensive disorders of pregnancy serve as risk factors for both ischemic and hemorrhagic strokes in pregnancy. [ahajournals.org]
Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011;25:391-403. [ PubMed ] Sibai BM1, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. [qims.amegroups.com]
Pathophysiology
No conclusive evidence supports a clear relationship between clinical conditions and specific imaging findings of severity or location of edema. [12], [13], [14] The underlying pathophysiology of PRES remains elusive. [sccj-sa.org]
Pathophysiology of PRES The exact mechanism of PRES is not yet fully elucidated. There exist two opposing pathophysiological mechanisms explanation. The first hypothesis is the vasospasm/hypoperfusion doctrine. [qims.amegroups.com]
The pathophysiology underlying preeclampsia remains incompletely characterized. [ahajournals.org]
PubMed/NCBI 15 Bartynski WS: Posterior reversible encephalopathy syndrome, part 2: Controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol. 29:1043–1049. 2008. [spandidos-publications.com]
However, risk factors include the following: Nulliparity Vascular disorders (eg, renal disorders, diabetic vasculopathy) Older ( > 35) or very young (eg, 17) maternal age Family history of preeclampsia Preeclampsia or poor outcome in previous pregnancies Pathophysiology [merckmanuals.com]
Prevention
[…] gestational diabetes and postpartum haemorrhage – the most common cause of maternal ... maternal age of more than 40 years, family history of pre- eclampsia and multiple pregnancy) may benefit from taking 150mg aspirin RCOG release: New measures to prevent [rcog.org.uk]
Can postpartum preeclampsia be prevented or avoided? This condition cannot be prevented or avoided. Know your body. If you have any of the symptoms listed, contact your doctor immediately. [familydoctor.org]
Medication to prevent seizures. Magnesium sulfate can help prevent seizures in women with postpartum preeclampsia who have severe signs and symptoms. Magnesium sulfate is typically taken for 24 hours. [drugs.com]
What can you do to prevent postpartum preeclampsia? It’s unclear whether postpartum preeclampsia can be prevented, but your doctor may recommend the following lifestyle changes: Follow a healthy diet. [whattoexpect.com]
Medication to prevent seizures. An anticonvulsive medication, such as magnesium sulfate, can help prevent seizures. Magnesium sulfate is typically taken for 24 hours. [nchmd.org]