Severe tricuspid regurgitation and seizure on postpartum day 10: case report of late postpartum eclampsia. Issue 6 (2nd November 2018)

• Record Type: Journal Article
• Authors: Vanden Eede, Martin; Schroyens, Matthew
• Is Part Of: Acta clinica belgica. Volume 73:Issue 6(2018)
• Page Start: 423
• Page End: 426
• Publication Date: 2018-11-02
• Subjects: Late postpartum eclampsia -- preeclampsia -- eclampsia -- pregnancy -- postpartum -- maternal mortality -- tricuspid regurgitation; Clinical medicine -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.005
• DOI: 10.1080/17843286.2018.1431014
• Languages: English
• ISSNs: 1784-3286

Abstract

Abstract: Objective and importance: Late postpartum eclampsia is characterized by pre-eclampsia and tonic-clonic seizures presenting more than 48 hours postpartum. It is a rare, frightening and dangerous complication that requires rapid recognition and adequate treatment. Clinical presentation: We present a case of late postpartum eclampsia, initially diagnosed as right-sided heart failure, 10 days postpartum.Two days after the delivery she developed mild swelling of both feet, progressive shortness of breath on exertion and orthopnea. Intervention: Transthoracic echocardiography revealed sever tricuspid regurgitation in combination with pulmonary hypertension. The patient wasadmitted to the intensive care unit (ICU) and a tentative diagnosis of pulmonary hypertension was made. On arrival in the ICU, the patient developed a tonic-clonic seizure and urinalysis revealed proteinuria, indicating eclampsia. Treatment of eclampsia was initiated with complete resolution of symptoms. Conclusion: This caseemphasizes the importance of considering late postpartum eclampsia in patients presenting with signs of pulmonary edema even several days after delivery, as early diagnosis and prompt initiation of appropriate antihypertensive and anticonvulsant therapy can prevent severe complications.