Atypical postpartum eclampsia in a 14-year-old woman: a rare case report

Introduction: Preeclampsia is a leading cause of maternal and child mortality worldwide. Recent studies reveal that some women develop preeclampsia without classic signs or outside the typical timeframe. Atypical cases are those that occur before 20 weeks of gestation and after 48 hours postpartum and/or have some signs and symptoms of preeclampsia without the usual hypertension or proteinuria. Case: A 14-year-old nulliparous woman with signs of labor for 6 hours before admission. History of routine pregnancy with the midwife. She had monthly checkups with no history of high blood pressure or seizures. After cesarean surgery, the patient experienced blurred vision and a 5-minute tonic-clonic seizure, followed by drowsiness. Blood pressure was 140/90 mmHg, and urine protein was +2. The patient was treated promptly with magnesium sulfate, starting with a 4 mg intravenous drip dose followed by a 6 mg bolus. The patient delivered a vigorous female neonate weighing 2700 grams, with a length of 47 cm and a head circumference of 31 cm. Conclusion: Atypical postpartum eclampsia without prior preeclampsia is rare and needs to be evaluated, especially in a patient with a high-risk pregnancy.