Late Postpartum Eclampsia with Postpartum Angiopathy: An Uncommon Diagnosis in the Emergency Department

Garg, Deepika; Rahaman, Brad; Stein, Evan G.; Dickman, Eitan

doi:10.1016/j.jemermed.2015.07.019

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…It was noted that if bradycardia was presumed secondary to anesthesia it would resolve within hours. The most common etiologies described by the authors for maternal bradycardia was medications, [8][9][10][11][12] primary conduction abnormalities, 5,13,14 preeclampsia, 15,16 anesthesia, 17 and peripartum cardiomyopathy. 18 Two case reports did not identify a clear cause for the patient's bradycardia.…”

Section: Resultsmentioning

confidence: 99%

“… 23 , 24 From our case series, ergotamine was the most common medication suspected of causing bradycardia. Pharmacological associations of maternal bradycardia described in the literature include magnesium sulfate, 9 , 12 betamethasone, 10 ergotamine, 11 and anesthetics. 25 We observed that when bradycardia was associated with medications or anesthesia, the time to recovery was much shorter than when it is associated with preeclampsia, underlying or cardiac causes.…”

Section: Discussionmentioning

confidence: 99%

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Post-partum maternal bradycardia: A case series and literature review

et al. 2023

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Background Unlike tachyarrhythmias, which are common in pregnancy, there is a paucity of data regarding maternal bradycardias. Our objective was to describe the characteristics, associated conditions, and prognosis of women who develop bradycardia post-partum. Method We conducted a retrospective chart review of patients referred to the Obstetrical Medicine service at British Columbia Women's Hospital from January 2012 to May 2020 for post-partum maternal bradycardia. Results Twenty-four patients with post-partum bradycardia were included (age 34.2 ± 4.8 years; heart rate 40.4 ± 8.1 beats per minute; blood pressure 131/72 mm Hg). Sinus bradycardia (79.2%) was the most common rhythm. Dyspnea (29.4%) and chest pain (23.5%) were common symptoms. Mean time to resolution of bradycardia was 3.6 ± 3.8 days. Associated conditions potentially explaining the bradycardia were preeclampsia (54.1%), underlying (16.7%), medications (8.3%), and neuraxial anesthesia (8.3%). Conclusions Maternal bradycardia is an uncommon condition complicating the post-partum period, that is generally self-limiting, with the majority only require clinical observation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Post-partum maternal bradycardia: A case series and literature review

et al. 2023

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“…Developing 48 hours after birth is considered late PPE [3]. Late PPE is a rare clinical entity [4]. In the differential diagnosis of PPE, cerebrovascular events such as hemorrhage and venous thrombosis, posterior leukoencephalopathy, and endocrine and electrolyte disorders should be considered [5].…”

Section: Discussionmentioning

confidence: 99%

A rare cause of late postpartum convulsion: Cerebral venous sinus thrombosis

Ergenoğlu¹

2022

Med-Science

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Cerebral venous sinus thrombosis (CVST) is a severe and rare pregnancy complication. The most common symptom is a headache. However, it is less common for headaches to be accompanied by seizures. Postpartum eclampsia (PPE) traditionally refers to convulsions within seven days, but convulsions can occur up to 4 weeks after birth. In this case report, we present our patient who developed cerebral venous sinus thrombosis, which is a very rare complication of the postpartum period and can be confused with late postpartum eclampsia.

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“…The present study demonstrated a statistically significant higher rate of hypertensive disorders in the women who attended the GER and suffered from hypertension during pregnancy or following birth. Previous studies report that women with hypertension had a higher proportion of acute care visits and higher rates of hospitalization in the postpartum period, including 11-44% rates of postpartum eclampsia [18,19]. Some women are discharged with antihypertensive medications.…”

Section: Discussionmentioning

confidence: 99%

Postpartum visits in the gynecological emergency room: How can we improve?

Weissmann-Brenner

Heusler

Manteka

et al. 2020

BMC Pregnancy Childbirth

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Background The attendance to the gynecological-emergency-room (GER) of women only a few weeks following previous discharge after birth comprises a medical as well as social problem. The objective of the study was to characterize the postpartum women that attended the GER, and depict the leading etiologies and risk-factors that lead them to attend the GER, and to examine correlations between their medical findings at discharge and the reasons for their attendance to the hospital. Methods All women that attended the GER between 01/01/2016 and 30/09/2016 during 6 weeks after birth were included. The variables assessed were: medical history, mode of birth, maternal complications of birth, diagnosis at the GER, treatment received and readmission. Results There were 446 visits of 413 women (5.6% of all deliveries). Most were generally healthy after their first normal vaginal birth with no complications during or following birth. 38.7% had a cesarean birth (p < 0.001). The most common causes of the visits were fever (30.3%), problems in episiotomy or surgical scar (26.6%) and abdominal pain (25.7%). Women with hypertensive disorders during birth had significantly more hypertensive problems in the GER. Diabetic women suffered statistically more from hypertensive disorder in the GER. 33.2% were examined and found healthy. Seventy-two women (1% of all deliveries) were hospitalized, most of them due to infection. Only 7.5% were referred to the GER due to bleeding. Conclusions Postpartum women are at risk of morbidities, especially following cesarean sections and in women with hypertensive disorders of during pregnancy. Scheduled visits to high-risk women to attend outpatient clinic sooner are recommended.

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Late Postpartum Eclampsia with Postpartum Angiopathy: An Uncommon Diagnosis in the Emergency Department

Cited by 7 publications

References 15 publications

Post-partum maternal bradycardia: A case series and literature review

Post-partum maternal bradycardia: A case series and literature review

A rare cause of late postpartum convulsion: Cerebral venous sinus thrombosis

Postpartum visits in the gynecological emergency room: How can we improve?

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