Atypical Post Partum Eclampsia and Posterior Reversible Encephalopathy Syndrome

Abstract

Pregnancy induced Hypertension also called as Gestosis plural Gestoses has a heterogeneous etiology. A case of atypical eclampsia with seizures in the postpartum, that required intravenous Magnesium sulphate is described. The two proposed theories of etiopathogeniesis of cerebral edema, Vasogenic Theory and Cytotoxic theory are discussed. The concept of delta hypertension is emphasized. Impaired fluid mobilization, decreased sodium excretion and imbalance between angiopoietic factors in the post partum period is discussed as the likely cause of post partum eclampsia. It can be concluded that it is important to monitor blood pressure in the postpartum state. The patients of atypical postpartum eclampsia with PRES, are likely explained by hyper dynamic circulation, delta hypertension and vasogenic theory. PRES is reversible, has classical clinico-radiological features in MRI and has good prognosis with treatment.