Does Preeclampsia Predict the Risk of Late Postpartum Eclampsia?

Abstract

Objective To investigate potential predictive symptoms of late postpartum eclampsia (LPE).

Study Design Retrospective review of patients delivered at a single academic medical center and diagnosed with eclampsia greater than 48 hours postdelivery.

Results Among 19 patients with eclampsia, 5 (26%) patients with confirmed eclampsia seized greater than 48 hours after delivery. None of these patients showed evidence of preeclampsia intrapartum or immediately postpartum and none received intrapartum magnesium sulfate. Prior to seizure activity, 4 of 5 (80%) patients had increased blood pressure and 2 of 5 (40%) had central nervous system symptoms (headache and visual changes).

Conclusion Gestational hypertension (GHTN) may be a risk factor for LPE. Consideration of seizure prophylaxis for patients with GHTN may facilitate the prevention of LPE.

Keywords

postpartum eclampsia - atypical eclampsia - eclampsia - late postpartum eclampsia (LPE)

Note

This research was presented at the 2010 ACOG Annual Clinical Meeting in San Francisco, California.

• References

• 1 Chesley LC, Cosgrove RA. Remote deaths following eclampsia. Obstet Gynecol 1954; 4: 165-176
• 2 Leitch CR, Cameron AD, Walker JJ. The changing pattern of eclampsia over a 60-year period. Br J Obstet Gynaecol 1997; 104: 917-922
• 3 Lubarsky SL, Barton JR, Friedman SA, Nasreddine S, Ramadan MK, Sibai BM. Late postpartum eclampsia revisited. Obstet Gynecol 1994; 83: 502-505
• 4 Chames MC, Livingston JC, Ivester TS, Barton JR, Sibai BM. Late postpartum eclampsia: a preventable disease?. Am J Obstet Gynecol 2002; 186: 1174-1177
• 5 Duley L, Gülmezoglu AM, Henderson-Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev 2010; (11) CD000025
• 6 Duley L, Henderson-Smart D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev 2000; (2) CD000127