Cerebral edema on MRI in severe preeclamptic women developing eclampsia.
OBJECTIVE
The aim of this study is to identify suitable applications for cerebral MR (magnetic resonance) scanning in cases of severe preeclampsia and eclampsia through comparison of clinical course and easily accessible parameters.


METHODS
From January 2001 to December 2003, cerebral MR scans were performed on 43 women with severe preeclampsia; of those 41 were enrolled in data analyses. Twenty clinical parameters, including age, body mass index, blood pressure, liver and renal function, and coagulation status, were compared for each patient. Data were analyzed using the SPSS program on a VAX main frame.


RESULTS
Among 41 severe preeclamptic women, abnormal MR images were observed in 11 cases including six with systemic seizures. Predictive accuracy of eclampsia with abnormal cerebral MR imaging was 84.9% (P=0.00001), while only 14.3% of severe preeclampsia cases had been diagnosed radiologically. Statistical analysis suggests diastolic BP and serum AST as predictive parameters for abnormal MR images with 82.9% predictive accuracy (P=0.0007).


CONCLUSIONS
Cerebral edema can be observed in preeclamptic patients developing eclampsia. Rapid delivery is indicated when diastolic BP and AST are elevated. MR scanning is useful when delivery is delayed due to fetal immaturityin cases of severe preeclampsia.
Matsuda
Hideo
H
Department of Obstetrics and Gynecology, National Defense Medical College, Japan. hmatsuda@ndmc.ac.jp
Sakaguchi
Kenichiro
K
Shibasaki
Tomoko
T
Takahashi
Hironori
H
Kawakami
Yuichi
Y
Furuya
Kenichi
K
Kikuchi
Yoshihiro
Y
D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000652:urine; D001795:Blood Pressure Determination; D001929:Brain Edema / Q000175:diagnosis* / Q000209:etiology*; D002533:Cerebral Angiography; D004461:Eclampsia / Q000150:complications* / Q000652:urine; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011225:Pre-Eclampsia / Q000150:complications* / Q000652:urine; D011247:Pregnancy; D011256:Pregnancy Outcome; D011507:Proteinuria / Q000209:etiology / Q000378:metabolism; D012680:Sensitivity and Specificity
D015415:Biomarkers