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24.04.2019 | Original Article | Ausgabe 4/2019

The Journal of Obstetrics and Gynecology of India 4/2019

Posterior Reversible Encephalopathy Syndrome (PRES): Evolving the Mystery of Eclampsia!

Zeitschrift:
The Journal of Obstetrics and Gynecology of India > Ausgabe 4/2019
Autoren:
Suman Sardesai, Rajiv Dabade, Sadhana Deshmukh, Pradeep Patil, Sachin Pawar, Arpita Patil
Wichtige Hinweise
Dr. Suman Sardesai is the Head of the Department of OGBYN, Ashwini Sahakari Rugnalaya Ani Sanshodhan Kendra, Solapur. Dr. Rajiv Dabade MD(OBGYN) is an Assistant Professor in Ashwini Rural Medical College and Hospital, Kumbhari, Solapur; Dr. Sadhana Deshmukh MD(OBGYN) is a Consultant in Ashwini Sahakari Rugnalaya and Sanshodhan Kendra, Solapur; Dr. Pradeep Patil MD(OBGYN) is an Assistant Professor in Ashwini Rural Medical College and Hospital, Kumbhari, Solapur; Dr. Sachin Pawar is a Resident in Ashwini Sahakari Rugnalaya and Snashodhan, Kendra, Solapur; Dr. Arpita Patil is a Resident in Ashwini Sahakari Rugnalaya and Sanshodhan, Kendra, Solapur.

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Abstract

Background

With the availability of neuroimaging, it is possible to know the exact underlying CNS pathology in eclampsia, and thus, the therapy can be targeted at the same. The present study was undertaken to find out the neurological changes in cases of eclampsia and to find the incidence of PRES in association with eclampsia and to study the role of Inj. Mannitol in cases of eclampsia with PRES who do not respond to Inj. MgSO4 alone.

Methods

This is a referral hospital-based prospective study of 110 consecutive cases of eclampsia who were subjected to MRI/CT scan brain without contrast. All 110 women with eclampsia were treated with routine principles of management of eclampsia. Inj. MgSO4 was the drug of choice as anticonvulsant. Inj. Mannitol was added as antiedema agent in patients who did not respond to MgSO4 alone.

Results

All patients of eclampsia showed PRES on neuroimaging. 40 (36.36%) patients received inj. Mannitol as they had either recurrent convulsions or extreme irritability or deep coma after multiple convulsions and did not recover consciousness after convulsions were controlled.

Conclusion

PRES is the core component of the pathogenesis of eclampsia, and the incidence is 100% in our study. Inj. MgSO4 is the drug of choice, and addition of Inj. Mannitol in cases with recurrent convulsions, extreme irritability, visual symptoms and severe headache plays a dramatic role in control of convulsions and recovery of the patients.

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