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Neuroimaging Features in Eclamptic Encephalopathy and their Correlation with Clinical and Laboratory Parameters: a Prospective Observational Study

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Abstract

Background

New onset seizures in pregnancy and postpartum are considered eclampsia as the default diagnosis. Other causes, such as intracranial haemorrhage, subarachnoid haemorrhage, cerebral venous sinus thrombosis or acute ischaemic stroke, have a similar mode of presentation, but need prompt diagnosis and institution of specific measures to decrease the risk of mortality and morbidity. Neuroimaging plays an important role in providing a specific diagnosis and hence aids in proper management. We hypothesised to find any correlation of laboratory parameters with neuroimaging abnormalities along with providing an insight to specific diagnoses in patients of new onset seizures in pregnancy with a presumptive diagnosis of eclampsia.

Methods

This was a hospital-based descriptive observational study conducted in SCB Medical College, Odisha, in the year 2018–2020 with a total of 70 clinically confirmed cases of eclampsia. They were subjected to cranial MR imaging along with routine investigations with no change in the emergency treatment protocol followed in the department. Data was compiled using Microsoft Excel 2016 and IBM SPSS statistics for Windows, version 27, and comparisons among MRI normal and abnormal group were stated.

Results

58 (82.86%) were MR imaging positive or abnormal, while 12 (17.14%) were MR imaging negative or normal. Cortical venous thrombosis without infarction was diagnosed in 25 (43.1%) patients, 6 (10.34%) had infarction, posterior reversible encephalopathy syndrome was seen in 19 (32.76%) cases, and 8 (13.79%) had hypertensive leukoencephalopathy. The mean gestational age at the time of presentation was significantly lower in the MRI abnormal group (p = 0.012). The AST and LDH values were found to be significantly higher in the MRI abnormal group, with p = 0.02 and 0.01, respectively.

Conclusion

Patients with imaging abnormalities have a severe form of disease in eclampsia. Neuroimaging in provisionally diagnosed cases of eclampsia will modify the management and hence prognosis in these patients.

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Acknowledgements

The authors are immensely grateful to Dr. Pallabi Thakur, Junior Resident, Dept. of Obstetrics and Gynaecology for her help in the collection of data.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Department of Radio Diagnosis, S.C.B. Medical College, Cuttack, Odisha, 753007, India

    Kirtirekha Mohapatra (Professor and HOD), Nahida Nigar Sultana (Associate Professor), Sasmita Behuria (Senior Resident) & Debaprasad Sahoo (Junior Resident)

  2. Department of Radiodiagnosis, JKMCH, Jajpur, Odisha, India

    Mamata Singh (Professor and HOD)

Authors
  1. Kirtirekha Mohapatra
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  2. Nahida Nigar Sultana
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  3. Sasmita Behuria
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  4. Debaprasad Sahoo
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  5. Mamata Singh
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Correspondence to Nahida Nigar Sultana.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in the study were in accordance with ethical standards of the institutional and/or national research committee. (Application No.-227/26.08.20).

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Informed consent was obtained from all participants included in the study.

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The study is conducted in the department of O&G and department of Radiology, S.C.B.Medical College, Cuttack.

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Mohapatra, K., Sultana, N.N., Behuria, S. et al. Neuroimaging Features in Eclamptic Encephalopathy and their Correlation with Clinical and Laboratory Parameters: a Prospective Observational Study. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-023-01899-w

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