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Category: Volume 08 Issue 06 June 2020
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Title: Neuro-imaging in severe hypertensive disorders of pregnancy and correlation with laboratory data: A study from North Indian tertiary health care institution

Authors: Anu Bala Chandel, Rohit Dogra

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.80

Abstract

Introduction: Cerebral & visual disturbances, epigastric pain, nausea, and vomiting, pulmonary edema, impaired liver function of unclear etiology & thrombocytopenia. RBC morphology is the strongest predictor of abnormal radiographic findings. The only laboratory parameter that has been found to be abnormal a week prior to the development of neurological symptoms is serum Lactate dehydrogenase (LDH) level which is higher in the group that later developed hypertensive encephalopathy related brain oedema. Alteration in Liver function tests (LFTs) includes elevated levels of serum aminotransferase, namely, aspartate aminotransferase (AST) or alanine aminotransferase (ALT).

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. Laboratory tests and 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. 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.

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 results should be subjected routinely to cranial imaging for the better perinatal outcomes.

Keywords: Antenatal women, Pregnancy induced hypertension, laboratory biochemical results, Neuro-imaging.

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Corresponding Author

Rohit Dogra

Department of Obstetrics and Gynaecology, Civil Hospital, Jaisinghpur, Kangra, Himachal Pradesh, India