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Archives of Gynecology and Obstetrics
Erschienen in: Archives of Gynecology and Obstetrics 6/2015

01.12.2015 | Review

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

verfasst von: Mauro Cozzolino, Claudia Bianchi, Giulia Mariani, Laura Marchi, Massimiliano Fambrini, Federico Mecacci

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2015

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Abstract

Purpose

Posterior reversible encephalopathy syndrome (PRES) is an usually reversible neuro-radiological clinical entity characterized by headache, confusion, visual disturbances or blindness and seizures. It rarely occurs without seizures.

Methods

We conducted a literature review in MEDLINE about PRES during post partum and pregnancy, focusing on differential diagnosis and therapy. We reviewed 28 articles (case reports, original articles and reviews) describing PRES as well as a case of a severe, immediate postpartum HELLP syndrome (haemolysis, elevated liver enzyme levels, low platelet count) with PRES without generalized seizure.

Results

The development of PRES after delivery is unusual. Magnetic resonance imaging represents the gold standard for the diagnosis of this condition. White matter oedema in the posterior cerebral hemispheres is typical on neuroimaging. PRES is reversible when early diagnosis is established and appropriate treatment is started without delay. The pathogenesis of PRES is discussed and the importance of a prompt diagnosis is emphasized, as the crucial role of rapid blood press reduction.

Conclusion

MRI is the diagnostic gold standard and it may be useful in the differential diagnosis. The goal of the therapy is to control elevated blood pressure and to prevent seizures or promptly manage it.
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Metadaten
Titel
Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum
verfasst von
Mauro Cozzolino
Claudia Bianchi
Giulia Mariani
Laura Marchi
Massimiliano Fambrini
Federico Mecacci
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 6/2015
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-015-3800-4

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