Management of atypical eclampsia with intraventricular hemorrhage: A rare experience and learning!

Abstract

Cerebrovascular accident during hypertensive disorder of pregnancy is a rare entity, but carries high risk of mortality and morbidity due to its unpredictable onset and late diagnosis. Here, we report an unusual case of 20-year-old primigravida with 34 weeks gestation having no risk factor, which developed sudden atypical eclampsia and intracranial hemorrhage within few hours. She was successfully managed by multidisciplinary approach including emergency cesarean section and conservative neurological treatment for intraventricular hemorrhage.

Optimizing Delivery Strategies in Eclampsia: A Comprehensive Review on Seizure Management and Birth Methods

“…Because 1/3 of patients with eclampsia develop all symptoms of HELLP syndrome, there is an increased risk of hemorrhage to the subarachnoid space, while regional anesthesia may constitute an additional risk, and it is not recommended in such situations [ 16 , 17 , 26 ]. Hemorrhage and spinal subarachnoid hematoma in women with HELLP syndrome have been observed [ 26 ].…”

“…International medical societies recommend regional anesthesia in situations when it is safe to be used to decrease the risk of aspiration and failed intubation attempts in women with preeclampsia [ 17 , 18 ]. The American College of Obstetricians and Gynecologists guidelines confirm that regional anesthesia can be used in severe preeclampsia patients who are free from coagulopathy and HELLP syndrome [ 19 ].…”