Detection of Unknown Pregnancy With Complications Using Point-of-Care Ultrasound

Eclampsia, a condition diagnosed in pre-eclamptic patients who experience seizures, can lead to maternal and fetal death if not treated early. The present case discusses the clinical management of an 18-year-old female who presented to the emergency department (ED) after a generalized tonic-clonic seizure. A physical examination revealed that she was also hypertensive. Based on these symptoms which required urgency due to the patient’s instability, and the suspicion that the patient could be pregnant, point-of-care ultrasound (POCUS) was performed. In this case, a POCUS was a faster more accessible modality than a urine or serum human chorionic gonadotropin test. Although the patient denied that she was pregnant, POCUS identified that she was approximately 22-24 weeks pregnant. The patient was promptly diagnosed with eclampsia and given medication to control her blood pressure and seizures. This case highlights the benefits of using POCUS in the ED to expedite clinical decisions by identifying the etiology of a patient’s condition and lends itself to the discussion of its utility in a critically ill pregnant woman. It also serves to reinforce the importance of keeping eclampsia as part of an emergency physician’s differential when confronted with a potentially pregnant patient with relevant symptoms.