Perioperative management of intra-partum seizure.
A young nulliparous woman previously diagnosed with pregnancy-induced hypertension suffered a seizure during active first stage labour. Pre-seizure blood pressure was borderline high but she did not fulfill other criteria for preeclampsia. She underwent emergency caesarean section for presumed eclampsia. Postoperatively, she deteriorated neurologically. CT scan showed an intracranial haemorrhage requiring neurosurgical intervention. The similarities of presentation of a primary cerebrovascular event and eclampsia following an intra-partum seizure made the differential diagnosis difficult.
Cheng
A Y
AY
Department of Anaesthesia, United Christian Hospital, Hong Kong.
Kwan
A
A
D000328:Adult; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002585:Cesarean Section; D003399:Craniotomy; D003937:Diagnosis, Differential; D004461:Eclampsia / Q000209:etiology*; D004630:Emergencies; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000150:complications; D007427:Intracranial Pressure; D007747:Labor Stage, First; D007744:Obstetric Labor Complications; D011225:Pre-Eclampsia / Q000175:diagnosis; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D014057:Tomography, X-Ray Computed