PMM.66 A case report on posterior reversible encephalopathy syndrome in a patient with pregnancy induced hypertension

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Abstract

Background

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state associated with unique magnetic resonance imaging (MRI). In pregnancy PRES is associated with pre eclampsia and eclampsia.

Background

Pre eclampsia and eclampsia induced PRES is managed by treating the cause. It is essential to treat PRES promptly in order to prevent permanent neurological deficits.

Case

AL is a 35 year old primiparous lady with a past medical history of hypertension treated conservatively. She developed a raised BP of 146/100 at 39+2 weeks, and treated with labetalol 200mg BD. Her pre-eclampsia bloods and urine protein creatinine ratio were normal. Due to her raised BP she was induced at 39+4 weeks. She delivered a live Male infant via vaginal delivery with no labour complications and later discharged home on labetalol.

Case

This lady was readmitted day 6 post delivery after collapsing at home. Her symptoms included severe headache, loss of vision, left sided hemiparesis and agitation. Her MAPS were between 131 to 146.

Case

The patient was initially treated with a magnesium infusion and three stat doses of labetalol and later admitted to ITU. Blood results showed continually rising ALT and creatinine and reducing levels of haemaglobin, platelets.

Case

This patient clinically improved while admitted and was discharged home one week later with no neurological deficit. She was diagnosed with pre-eclampsia induced PRES and HELP syndrome.

Conclusion

This is case study of a 35 year old woman with an antennal history of pregnancy induced hypertension. She developed neurological symptoms characterised by PRES.

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