Late postpartum eclampsia coincident with postdural puncture headache: a case report.
Preeclampsia developed in this patient 4 days' postpartum. Visual changes, headache, and elevated blood pressures were present on arrival to the emergency department. Coincident with the preeclampsia was a postdural puncture headache complicating the diagnosis of late postpartum preeclampsia. Pregnancy-induced hypertension laboratory values were normal, and relief of the postdural headache and visual disturbances was obtained after placement of an epidural blood patch. Blood pressures continued to increase, however, and late postpartum eclampsia developed. We conclude that symptoms of a postdural puncture headache can mimic those of postpartum preeclampsia. Early recognition and treatment of postpartum preeclampsia may decrease patient mortality and morbidity by preventing late postpartum eclampsia.
Winston
Anthony W
AW
Navy Nurse Corps Anesthesia Program, Naval School of Health Sciences, Portsmouth, Va., USA.
Norman
David
D
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017217:Blood Patch, Epidural; D001795:Blood Pressure Determination; D003937:Diagnosis, Differential; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D005260:Female; D006261:Headache / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D006830:Hydralazine / Q000627:therapeutic use; D008278:Magnesium Sulfate / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011247:Pregnancy; D011644:Puerperal Disorders / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D013129:Spinal Puncture / Q000009:adverse effects*
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D006830:Hydralazine; D008278:Magnesium Sulfate