Abstract

LACUNZA PAREDES, Rommel Omar; SANTIS MOYA, Fernanda; JIMENEZ ESPINOZA, Marlon Lluem  and  VERA DEL CARPIO, Carlos. Epidemiology and neurological manifestations associated with eclampsia in a Peruvian reference hospital. A case series. Rev. peru. ginecol. obstet. [online]. 2018, vol.64, n.2, pp.163-168. ISSN 2304-5132.  http://dx.doi.org/https://doi.org/10.31403/rpgo.v64i2073.

The “premonitory symptoms” of eclampsia can be interpreted as actual symptoms of cerebral involvement within the posterior reversible leukoencephalopathy syndrome, and eclampsia as a severe symptom of the same syndrome. Objective: To review the characteristics of women with eclampsia in a national hospital, with emphasis on the associated neurological manifestations. Design: Case series. Institution: Hospital Nacional Daniel Alcides Carrion (HNDAC), Lima, Peru. Patients: Women with eclampsia. Methodology: Study of all patients with eclampsia over a period of 5 years and 6 months. Eclampsia cases that occurred outside the institution or with insufficient data were excluded. Main outcome measures: General characteristics, associated symptoms, complications and laboratory values in eclamptic patients. Results: Thirty-nine cases were reported. The incidence of eclampsia in pregnant women was 0.19%. The mean age was 21 years; 75.8% of the women were primiparous and 44.4% were less than 34 weeks pregnant. 69.7% of them were diagnosed before delivery; 51.5% had blood pressure above 160/110 mmHg and 12.1% had no hypertension. 93.9% presented symptoms, mainly headache (87.9%), as well as visual (27.2%) and auditory (12.1%) disturbances. Two patients had headache and normal blood pressure, and 2 cases were asymptomatic. Complications were: sensory alterations, abruptio placentae (15.2%), HELLP syndrome (15.2%) and difficult-to-control hypertension (39.4%). There were neither maternal nor perinatal deaths. Conclusions: The neurological manifestations that precede eclampsia are variable and do not have a constant correlation with the severity of maternal hypertension.

Keywords : Eclampsia; Hypertensive disorder of pregnancy; Posterior reversible leukoencephalopathy syndrome PRES.

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