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Category: Volume 08 Issue 06 June 2020
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Title: To determine the distribution and nature of cranial MR imaging findings in patients with severe preeclampsia & eclampsia and to evaluate their correlation with clinical and laboratory data: A study from North Indian tertiary health care institution

Authors: Dr Rama Thakur, Dr Rohit Dogra, Dr Vijay Thakur

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.60

Abstract

Introduction: Hypertensive disorders of pregnancy comprising of pre-eclampsia and eclampsia are a major cause of adverse pregnancy outcomes. Neurological manifestations of pregnancy induced hypertension are the most common cause of maternal and foetal morbidity and mortality. Cranial neuro-imaging reveals focal regions of symmetric hemispheric oedema; with parietal and occipital regions getting most commonly affected.

Methods: The study was conducted among 65 antenatal women diagnosed with pre-eclampsia and eclampsia at gestational age >20 weeks in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and child IGMC Shimla. Clinical signs and symptoms, Laboratory tests neuroimaging findings were recorded for study purpose.

Results: About 17.6% of severe pre-eclampsia and 100% of eclampsia had findings observed on cranial MRI. Headache and visual complaints were most frequently recorded. PRES was the predominant neuroradiographic finding in present study and occipital lobe was commonly affected region. In subjects with MR imaging findings, hematocrit, LDH, serum uric acid and ApTT were significantly higher than those without MR imaging findings. Subjects with MRI finding had abnormal RBC morphology whereas none of MR negative subjects had abnormal RBC morphology. No significant difference was observed regarding blood pressure parameters between MRI positive and negative subjects.

Conclusion: Neuroimaging in antenatals with severe hypertensive disorders might aid in better understanding of the poorly explained phenomenon. In addition this would be helpful in better management of the disorders along with their much dreaded complications. Patients with hypertensive disorders of pregnancy with deranged biochemical tets should be subjected routinely to cranial imaging for the better perinatal outcomes.

Keywords: Antenatal women, Pregnancy induced hypertension, Biochemical tests, neuro-imaging.

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Corresponding Author

Dr Rohit Dogra

Department of Obstetrics and Gynecology Civil Hospital Jaisinghpur