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Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity initially described in 1996. PRES frequently develops in patients with preeclampsia and eclampsia. There is not much literature on risk factors causing PRES in pregnant patients with eclampsia. This study aimed...

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Autores principales: Shaikh, Nissar, Nawaz, Shoaib, Ummunisa, Firdous, Shahzad, Aamir, Hussain, Jazib, Ahmad, Kiran, Almohannadi, Haleema S, Sharara, Hussein Attia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: HBKU Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466280/
https://www.ncbi.nlm.nih.gov/pubmed/34604007
http://dx.doi.org/10.5339/qmj.2021.4
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author Shaikh, Nissar
Nawaz, Shoaib
Ummunisa, Firdous
Shahzad, Aamir
Hussain, Jazib
Ahmad, Kiran
Almohannadi, Haleema S
Sharara, Hussein Attia
author_facet Shaikh, Nissar
Nawaz, Shoaib
Ummunisa, Firdous
Shahzad, Aamir
Hussain, Jazib
Ahmad, Kiran
Almohannadi, Haleema S
Sharara, Hussein Attia
author_sort Shaikh, Nissar
collection PubMed
description Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity initially described in 1996. PRES frequently develops in patients with preeclampsia and eclampsia. There is not much literature on risk factors causing PRES in pregnant patients with eclampsia. This study aimed to determine the incidence of PRES in eclampsia, its association with pregnancy, risk factors, and maternal and perinatal outcomes. Patients and methods: All patients who were admitted with eclampsia and developed PRES in an intensive care unit of a tertiary medical facility between 1997 and 2017 were included in the study. Patients’ demographics, pregnancy and gestational data, treatment mode, and outcomes were retrospectively obtained from their medical charts/files. Data were entered using SPSS program version 23. Chi-square test was used to compare the variables, and a p value of < 0.05 was considered statistically significant. Results: A total of 151 patients were admitted during the study period, and 25 developed PRES. The diagnosis was common in patients older than 25 years. Eclampsia patients who developed PRES were without any pregnancy-associated comorbidities (p < 0.08). At the time of diagnosis, their gestational age was more than 36 weeks, which was significant (p < 0.04). Incidence was significantly higher in patients presenting with eclampsia and had recurrent seizures (p < 0.01 and 0.002, respectively). Its incidence was significantly higher in postpartum eclampsia patients (p < 0.01). It was also significantly higher in patients who had cesarean section and hypertension treated with labetalol (p < 0.001 and 0.02, respectively). Overall, the maternal mortality rate of eclampsia patients complicated with PRES was 4% in our population. Conclusion: Of eclampsia patients, 16% developed PRES, which is on the lower side than the reviewed literature (10%–90%). Eclampsia on presentation, recurrent seizures, postpartum eclampsia, cesarean delivery, and labetalol use were associated with increased risk of PRES development.
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spelling pubmed-84662802021-10-01 Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes Shaikh, Nissar Nawaz, Shoaib Ummunisa, Firdous Shahzad, Aamir Hussain, Jazib Ahmad, Kiran Almohannadi, Haleema S Sharara, Hussein Attia Qatar Med J Research Article Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity initially described in 1996. PRES frequently develops in patients with preeclampsia and eclampsia. There is not much literature on risk factors causing PRES in pregnant patients with eclampsia. This study aimed to determine the incidence of PRES in eclampsia, its association with pregnancy, risk factors, and maternal and perinatal outcomes. Patients and methods: All patients who were admitted with eclampsia and developed PRES in an intensive care unit of a tertiary medical facility between 1997 and 2017 were included in the study. Patients’ demographics, pregnancy and gestational data, treatment mode, and outcomes were retrospectively obtained from their medical charts/files. Data were entered using SPSS program version 23. Chi-square test was used to compare the variables, and a p value of < 0.05 was considered statistically significant. Results: A total of 151 patients were admitted during the study period, and 25 developed PRES. The diagnosis was common in patients older than 25 years. Eclampsia patients who developed PRES were without any pregnancy-associated comorbidities (p < 0.08). At the time of diagnosis, their gestational age was more than 36 weeks, which was significant (p < 0.04). Incidence was significantly higher in patients presenting with eclampsia and had recurrent seizures (p < 0.01 and 0.002, respectively). Its incidence was significantly higher in postpartum eclampsia patients (p < 0.01). It was also significantly higher in patients who had cesarean section and hypertension treated with labetalol (p < 0.001 and 0.02, respectively). Overall, the maternal mortality rate of eclampsia patients complicated with PRES was 4% in our population. Conclusion: Of eclampsia patients, 16% developed PRES, which is on the lower side than the reviewed literature (10%–90%). Eclampsia on presentation, recurrent seizures, postpartum eclampsia, cesarean delivery, and labetalol use were associated with increased risk of PRES development. HBKU Press 2021-02-16 /pmc/articles/PMC8466280/ /pubmed/34604007 http://dx.doi.org/10.5339/qmj.2021.4 Text en © 2021 Shaikh, Nawaz, Ummunisa, Shahzad, Hussain, Ahmad, Almohannadi, Sharara, licensee HBKU Press. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Shaikh, Nissar
Nawaz, Shoaib
Ummunisa, Firdous
Shahzad, Aamir
Hussain, Jazib
Ahmad, Kiran
Almohannadi, Haleema S
Sharara, Hussein Attia
Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title_full Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title_fullStr Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title_full_unstemmed Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title_short Eclampsia and posterior reversible encephalopathy syndrome (PRES): A retrospective review of risk factors and outcomes
title_sort eclampsia and posterior reversible encephalopathy syndrome (pres): a retrospective review of risk factors and outcomes
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466280/
https://www.ncbi.nlm.nih.gov/pubmed/34604007
http://dx.doi.org/10.5339/qmj.2021.4
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