Postpartum eclampsia- a clinical study

ABSTRACT Background Eclampsia, an enigmatic multisystem complication of pregnancy, is commonly defined as new onset of grand mal seizure activity and /or unexplained coma during pregnancy or postpartum. Eclampsia is associated with maternal deaths ranging from, 1.8% in developed to 14% in developing countries respectively. The worldwide incidence of delayed postpartum eclampsia is on an increasing trend , now at 16-18% ,of all eclamptic seizures. Objective To study the clinical findings and morbidity, associated with postpartum eclampsia and its correlation with neuroimaging- in our institute- SRIHER, CHENNAI. Materials and methods This is a retrospective study from a period of June 2016- June 2021 , in SRIHER, Chennai. Case records of all patients with postpartum eclampsia were analysed. Results A total of 35 patients who satisfied the inclusion criteria were studied, out of which 55% of patients were diagnosed with hypertension or preeclampsia antenatally, and 45% presented as atypical eclampsia. In our institution, Postpartum eclampsia commonly occurred in the age group of 26-30 years of age (51.4%) ; was common after LSCS (71.4%) ; most commonly occurred immediate postpartum (42.8%), Most common prodromal symptom was headache (77%), followed by blurring of vision (37%). Most common MRI finding was PRES (69%). 17% patients required ICU care. There was no mortality associated with postpartum eclampsia in the study period. Conclusion This study emphasises that a high index of suspicion and a multidisciplinary approach effectively reduces mortality and morbidity associated with postpartum eclampsia. Neuroimaging is of robust help in the diagnosis and management.