Computed tomography scan findings in eclampsia: a prospective study
Keywords:CT scan, Eclampsia, Maternal outcome
Background: Eclampsia is a leading cause of maternal death, with classical neurological symptoms that include headache, nausea, vomiting, cortical blindness, coma and convulsions. Computed tomography (CT) scan helps in diagnosing and management of eclampsia in pregnant women. The present study was done with the objective to analyse the findings of CT scan of brain in eclampsia, to identify the prevalence of neurovascular complications in these cases and to determine if these findings can be of value in determining the prognosis of this disorder.
Methods: This was a prospective study done on 100 patients with eclampsia. All of the 100 patients were screened with CT scan brain at Institute of Obstetrics and Gynaecology, Egmore, Chennai during the period from August 2008 to August 2009. All the data were analyzed and compared between the groups of positive CT scan and negative CT scan observations.
Results: Out of 100 patients, positive CT scan findings were noticed in 15 patients. Of them, 7 patients expired, and 8 patients survived after treatment. Of the expired patients (7), 5 of them expired due to brain haemorrhage, and 1 patient died with cerebral oedema and 1 with brain infarction. Cerebral odema (46%) was the most common positive CT finding. Parietal region of brain was the most common (40%) affected area.
Conclusions: CT scan of brain provides valuable information in determining the prognosis and the prevalence of neurovascular complications in Eclampsia.
Das R, Biswas S. Eclapmsia: the major cause of maternal mortality in Eastern India. Ethiop J Health Sci. 2015;25(2):111-6.
Micheal BB. Eclampsia. Emer Med J. 2000;74:1-10.
Patil MM. Role of neuroimaging in patients with atypical eclampsia. J Obstet Gynaecol India. 2012;62(5):526-30.
Cipolla MJ. Cerebrovascular function in pregnancy and eclampsia. Hypertension. 2007;50(1):14-24.
Zhu XW. Cerebral lesions in severe PIH: 61 cases study with computed tomographic scan. Zonghua Chan Ke Za Chi. 1993;28(5):275-7,313.
Goldenberg RL, McClure EM, MacGuire ER, Kamath BD, Jobe AH. Lessons for low-income regions following the reduction in hypertension-related maternal mortality in high-income countries. Int J Obstet Gynecol. 2011;113(2):91-5.
Danso KA, Opare-Addo HS. Challenges associated with hypertensive disease during pregnancy in low-income countries. Int J Obstet Gynecol. 2010;110(1):78-81.
Dasari P, Habeebullah S. Maternal mortality due to hypertensive disorders of pregnancy in a tertiary care center in Southern India. Int J Obstet Gynaecol. 2010;110(3):271-3.
Leitch CR, Cameron AD, Walker JJ. The changing pattern of eclampsia over a 60-year period. Br J Obstet Gynaecol. 1997;104(8):917-22.
Chakravarty A, Chakrabarti SD. The neurology of eclampsia: some observations. Neurol India. 2002;50(2):128-35.
Khandaker S, Haldar M, Munshi S. Intra Cerebral Changes Detected by CT Scan of Brain in Eclampsia. Austin J Obstetrics Gynecol. 2014;1(3):1-4.
Milliez J, Dahoun A, Boudraa M. Computed tomography of the brain in Eclampsia. Obstet Gynaecol. 1990;75(6):975-80.
Harandou M, Madani N, Labibe S, Messouak O, Boujraf S, Benkirane S, et al. [Neuroimaging findings in eclamptic patients still symptomatic after 24 hours: a descriptive study about 19 cases]. Ann Fr Anesth Reanim. 2006;25(6):577-83.
Hira B, Moodley J. Role of cerebral computerised tomography scans in Eclampsia. J Obstetrics Gynaecol. 2004:24(7):778-9.
Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry. 1988;51(3):416-21.