Observational Study of Maternal and Fetal Outcome in Posterior Reversible Encephalopathy Syndrome in Eclamptic Women in a Tertiary Care Institute

Background: About 25% of all antenatal admissions are related to hypertensive disorders, which are the most prevalent medical complication of pregnancy, affecting 7-15% of all gestations.One of the main causes of the elevated mortality and morbidity rates for both the mother and the fetus is the well-known complication of eclampsia, posterior reversible encephalopathy syndrome (PRES), which involves abrupt neurological abnormalities.Objectives: To study the maternal outcome in terms of intensive care unit (ICU) admission, mortality, convulsion episodes, and hypertension control; to study the fetal outcome in terms of appearance, pulse, grimace, activity, respiration (APGAR) at birth, hypoxic complications, age of gestation at birth, and neonatal morbidity; and to observe the outcome and control of hypertension after giving MgSO 4 for the treatment of eclampsia.Methodology: An observational prospective study was conducted among 30 patients with PRES secondary to eclampsia after 20 weeks of gestation or up to 42 days postpartum period, and the maternal and fetal outcomes were studied after giving MgSO 4 for the management of the same.Results and observations: Out of 30 patients, 100% patients presented with convulsion, followed by headache in 83% patients, followed by visual disturbance in 36% patients.MgSO 4 was used in all patients and was found to be effective in controlling convulsions in all (100%).A total of 40% patients needed ICU care.A total of 46.66% patients had blood pressure (BP) more than 160/100 mm Hg.A total of 73.3% patients underwent cesarean section.A total of 16.6% patients had hemolysis, elevated liver enzymes, low platelet count (HELLP).A total of 3.3% had disseminated intravascular coagulation (DIC), went into multiorgan dysfunction syndrome (MODS), and passed away due to the same.A total of 43.3% babies had birth weight between 1500 and 2499 gm.A total of 73.3% patients had preterm delivery, and 70% babies required neonatal intensive care unit (NICU) admission.There were 13% neonatal deaths (NNDs), 10% intrauterine fetal death (IUFD), and 20% had intrauterine growth retardation (IUGR).A total of 53.3% patients had APGAR <7.A total of 26.7% babies had complications secondary to prematurity.Conclusion: Since PRES as a complication of eclampsia is associated with high mortality and morbidity both for the neonate and the mother, a high degree of clinical suspicion with early confirmation using imaging modalities with timely intervention using MgSO 4 and antihypertensives, as well as management of other associated conditions, can make this condition truly reversible.