ЭКЛАМПСИЯ И СИНДРОМ ЗАДНЕЙ ОБРАТИМОЙ ЭНЦЕФАЛОПАТИИ В РАННЕМ ПОСЛЕРОДОВОМ ПЕРИОДЕ ПОСЛЕ ПРЕЖДЕВРЕМЕННЫХ РОДОВ ДВОЙНЕЙ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

Abstract

Eclampsia is a rare but potentially fatal complication of pregnancy, childbirth, and the postpartum period. The risk of developing it is significantly higher in multiple pregnancies. The initial seizure often occurs during or after delivery frequently against a background of blood pressure readings that appear satisfactory which complicates prediction and necessitates a high level of clinical vigilance.
The case report presented here illustrates the unpredictable onset of eclampsia in the early postpartum period despite relatively stable blood pressure readings prior to delivery; it highlights the need for neuroimaging to confirm posterior reversible encephalopathy syndrome (PRES), the importance of timely differential diagnosis regarding thrombotic microangiopathies, and the value of a multidisciplinary approach, including the use of telemedicine, in managing patients with severe obstetric complications.
We describe the case of a 20-year-old patient whose early postoperative period was complicated by atonic uterine hemorrhage; several hours later, she experienced her first generalized tonic-clonic seizure, followed by the development of multiorgan failure (involving the cardiovascular, cerebral, hepatic, and renal systems, as well as pancytopenia). Brain MRI revealed multiple cortical-subcortical lesions in the frontal, parietal, and occipital lobes, consistent with posterior reversible encephalopathy syndrome. Complete neurological, hematological, and hepatic recovery was achieved through the administration of magnesium sulfate, antihypertensive and antibacterial agents, and replacement therapy.