Neuroimaging in eclamptic patients and its clinical implications
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231220Keywords:
Posterior reversible encephalopathy syndrome, Magnesium sulphate, Hypertensive disorders of pregnancyAbstract
Background: Aim of the study is to assess the utility of neuroimaging (CT/MRI) in eclamptic patients and correlating their clinical implications and to study the role of Injection Mannitol in case of Eclampsia who did not respond to injection magnesium sulphate alone.
Methods: This prospective study was conducted in Pannadhay Mahila Chikitsalya Udaipur, RNT Medical College Udaipur, Rajasthan. 50 eclamptic patients fulfilling the inclusion and exclusion criteria were subjected to neuroimaging CT/MRI from August 2021 to August 2022. Injection Mannitol was added in eclamptic patients who did not respond to injection magnesium sulphate alone.
Results: In this study neuroimaging were normal in 42% cases while 58% cases had pathological changes; PRES, haemorrhage, infarction, ischemia etc. Out of these PRES was seen in 48% cases. Mannitol was given in 14% patients and only one patient did not respond to mannitol.
Conclusions: This study revealed that PRES was the main neurological component among patients. Neuroimaging helps in better management of eclampsia. Mannitol holds utility in managing the patients unresponsive to injection magnesium sulphate.
References
Magley M, Hinson MR. Eclampsia. Treasure Island (FL): Star Pearls Publishing; 2022.
Deshmukh V, Nasrin A, Gadappa SN. Thrombocytopenia in hypertensive disorders of pregnancy: maternal and perinatal outcome. New Indian J Obgyn. 2022;8(2):233-9.
Mahela S, Sarma HD, Mech T, Talukdar B. Computed tomography of brain in eclampsia and its clinical correlation. New Indian J Obgyn, 2021;8(1):14-8.
Sailaja B, Cooly V, Salicheemala B, Salaija S. A study on high risk factors, maternal and fetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India. Int J Reprod Contracept Obstet Gynecol. 2018;7:266-71.
Wilkerson RG, Ogunbodede AC. Hypertensive disorders of pregnancy. Emerg Med Clin North Am. 2019;37(2):301-16.
Gasnier R. Eclampsia: an overview clinical presentation, diagnosis and management. MOJ Womens Health. 2016;3(2):182-7.
Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334(8):494-500
Sardesai S, Dabade R, Deshmukh S, Patil P , Pawar S, Patil A. Posterior reversible encephalopathy syndrome: evolving the mystery of eclampsia. J Obstet Gynecol India. 2019;69(4):334-8.
Fisher N, Saraf S, Egbert N, Hamel P, Stein EG, Minkoff H. Clinical correlates of posterior reversible encephalopathy syndrome in pregnancy. J Clin Hypertens. 2016;18(6):522-7.
Ajah LO, Ozonu NC, Ezeonu PO, Lawani LO, Obuna JA, Onwe EO. The fetomaternal outcome in eclampsia in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5:4329-34.
Eswari S. Study on correlation between neuroimaging and neurological presentation in antepartum and postpartum eclampsia and its Maternal outcomes. Thesis, 2016.
Begum F, Nahar K, Ahmed MU, Ferdousi RA, Akter FA, Rahman MM. Study on neurological manifestations of eclampsia and findings of CT scan of brain. Mymensingh Med J. 2015;24(4):691-6.
Ugran SM, Donimath KV. Correlation between neuroimaging and neurological presentation in antepartum and postpartun eclampsia. Int J Reprod Contracept Obstet Gynecol. 2016;5:419-24.
Mayama M, Uno K, Tano S, Yoshihara M, Ukai M, Kishigami Y, et al. Incidence of posterior reversible encephalopathy syndrome in eclamptic and patients with preeclampsia with neurologic symptoms.Am J Obstet Gynecol. 2016;215(2):239.e1-5.
Thomas DR, Beenakumari R, Priya V. Maternal and fetal outcome in women with neurological disorders. Int J Reprod Obstet Gynecol. 2019;8:4891-6.
