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Volume 3
Journal of Reproductive Biology and Endocrinology
WCGO2019
May 13-14 , 2019
Gynecology and Obstetrics
May 13-14 , 2019 Tokyo, Japan
2
nd
World Congress on
An unusual presentation of eclampsia
Nicholas Dilley
International Association for Medical Education, Australia
Background:
Eclampsia complicates around 1 in 2000 pregnancies and is one of the major causes of maternal
death. Nearly 50% of cases can occur without signs and symptoms of pre-eclampsia. This case highlights
the issue of rapid onset eclampsia with no previous evidence of pre-eclampsia and the possibility of rapid
deterioration.
Case presentation:
A 31-year-old primigravida patient presented for induction of labour at 39 weeks from
prolonged pre-labour rupture of membranes. The patient had a low risk pregnancy otherwise. She had an
isolated blood pressure of 180/105mmHg three hours post commencement of oxytocin. This was effectively
treated with oral labetalol. The patient remained asymptomatic of eclampsia throughout, however suddenly
progressed to have a two-minute tonic clonic seizure. She was treated withmagnesium sulphate and transferred
for emergency caesarean section. Intraoperative platelet count decreased to 26 (from 202) prompting a
diagnosis of disseminated intravascular coagulation. On day two postpartum the patient developed dizziness
and blurred vision. MRI brain demonstrated FLAIR hyperintensity and a diagnosis of posterior reversible
encephalopathy syndrome was made. These symptoms resolved spontaneously by discharge.
Conclusion:
Eclampsia remains a major cause of maternal mortality and almost 1 in 50 women who suffer
an eclamptic seizure will die as a result. This case highlights the potential atypical presentations of eclampsia
and the importance of early recognition to avoid potentially fatal eclamptic seizures. As a multidisciplinary
team we must be vigilant in our assessment of hypertension or indeed any symptoms of eclampsia to ensure
prompt treatment.
Biography
Dr Nicholas Dilley is a senior resident medical officer at in Western Sydney and has previously presented at the International Association
for Medical Education. Dr Reena Mohan is a consultant obstetrician and gynaecologist for Western Sydney Local Health District.
nick.dilley@me.comJ Reprod Biol Endocrinol, Volume 3