Clinical spectrum of Posterior Reversible Encephalopathy Syndrome (PRES) in patients with eclampsia

Abstract

Objective: To identify the prevalence, demographic details and clinical features of PRES in women suffering from eclampsia. Methods: Women admitted in the labor room suite with diagnosis of eclampsia were studied. The study period was from October 15. 2011 to March 15. 2012, in the department of obstetrics & gynecology unit 3, Civil hospital Karachi.Of all patients with diagnosis of eclampsia, 22 underwent neuro imaging by computerized tomography. Demographic details, clinical findings and maternal and perinatal outcome were entered on a predesigned Performa. Results: Thirty four women were identified, with eclampsia. Neuro imaging was done in 22 women. Posterior reversible encephalopathy syndrome was recognized in 9 (22) patients. The mean systolic blood pressure was 161(±11) mm Hg, and mean diastolic blood pressure was 111(±10) mm Hg. Mean number of fits were three, and the mean gestational age of patients were 35 weeks. Gestational age was found significantly associated with PRES (p <0.3) Mean leukocyte count in patients with eclampsia was 20,083±16,165/ cu mm. Conclusion: Our study shows presence of Posterior reversible encephalopathy syndrome (PRES) in women who are identified with eclampsia. There is need for awareness and long term neurological follow up in this group of women.